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The aim of this prospective study was to analyze the technical feasibility, success rate and special complications of percutaneous coronary interventions (PCI) using a newly released 5 French (Fr) guiding catheter with an inner diameter of 0.058 . The study was performed in 1,200 consecutive patients subjected to coronary angioplasty. In 92% of the patients, the intervention was started with a 5 Fr catheter; in 8% of the patients, a 6 or 7 Fr catheter was used. In 5% of the 1,105 patients, the guiding catheter had to be changed during PCI from 5 Fr to a 6 or 7 Fr catheter. In 92% of the patients, the intervention was successfully performed using a 5 Fr catheter. In 3%, the overall success rate was 95% after changing the guiding catheter. Predictors of procedural failure with the 5 Fr guiding catheter were type C lesion morphology and a diameter stenosis of 99% and 100%. The success rate was 90% in acute functional occlusions and 63% in chronic total occlusions (CTO). In CTOs, predictors of procedural failure of the recanalizations using 5 Fr guiding catheters were sidebranch at the point of the total occlusion, complex lesion morphology type C and abrupt morphology of the occlusion. This study confirms that PCI was technically feasible using a 5 Fr guiding catheter in the majority of consecutive patients (success rate: 92%). There were significant differences in the success rate depending on the lesion type and the diameter stenosis.

Aims: In experimental studies the recovery of pressure distal to stenotic valve orifices has been well described. We evaluated the extent, determinants, and clinical importance of pressure recovery in patients with aortic valve stenosis., Methods and Results: The study was performed in 37 patients with aortic valve stenosis, in whom cardiac catheterization was performed and left ventricular and aortic pressures were determined using a high-fidelity multi-tip micromanometer catheter. To register the pressure waveforms accurately the catheter was positioned so that the proximal micromanometer was in the left ventricle, the second at the site of minimal pressure in the vena contracta, and the third (the most distal) in the ascending aorta 16 cm further downstream. The amount of pressure recovery within the ascending aorta was up to 44% of the maximal pressure drop. The index pressure recovery was directly correlated to the Gorlin-derived aortic valve area (r=0.80) and indirectly correlated to the ratio of aortic valve area and the cross-sectional area of the ascending aorta., Conclusions: This clinical study confirmed experimental data, that index pressure recovery is dependent on the ratio of the effective valve area and the cross-sectional area of the ascending aorta. Pressure recovery may need to be considered in patients with mild to moderate aortic stenosis and with a small cross-sectional area of the ascending aorta., (Copyright 1999 The European Society of Cardiology.)