EVALUATION OF THE SYSTEMATIC USE OF A NEW-TYPE OF DIAGNOSTIC INTERVENTIONAL 6F CATHETERS FOR CORONARY ANGIOGRAPHY AND ANGIOPLASTY

Coronary angioplasty performed immediately after coronary angiography has raised interest to develop diagnostic catheters potentially usable for interventions (i.e. Diaventional(TM) catheters). To evaluate the performance and cost-effectiveness of such material, we performed a prospective study in 100 consecutive patients with a >50% pre-angiographic likelihood of coronary angioplasty in 85 of them. Angioplasty was actually performed in 61 patients. Of the 56 (92%) immediate angioplasty procedures, 33 (59%) were performed successfully with the Diaventional(TM) catheter chosen initially. In 23 cases, another guiding catheter was used for technical failure (2 cases) or because of operator's choice (21 cases). Angiographic success of angioplasty procedures was 97% with Diaventional(TM) and 91% with ''standard'' guiding catheters. Based on current market prices, the costs of the systematic use of such diagnostic/interventional catheters were 11% less than the projected costs of the standard strategy. Thus, this new type of catheter is both safe and cost-effective for the majority of coronary angioplasty procedures ''at first sight.'' It could become a logical first choice for diagnostic coronary angiography, when the likelihood of immediate subsequent angioplasty is high and at relatively low risk. (C) 1994 Wiley-Liss, Inc.