{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:30:41Z","timestamp":1790616641932,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n We aimed to examine the procedural characteristics and safety profile of slender percutaneous coronary interventions (PCI) using a 5 Fr or smaller sheath.<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Smaller catheter size has been associated with fewer complications in PCI.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Our retrospective observational study included 259,401 cases of stable elective PCI from the Japan Percutaneous Coronary Intervention Registry between 2021 and 2022. Based on sheath size, cases were categorized into the slender group (5 Fr or smaller,\n n<\/jats:italic>\n \u2009=\u200928,300) and the non\u2010slender group (6 Fr or larger,\n n<\/jats:italic>\n \u2009=\u2009231,101).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The slender group was associated with more radial access (88.6% vs. 74.2%:\n p<\/jats:italic>\n \u2009<\u20090.001), fewer PCI failures (1.7% vs. 2.8%,\n p<\/jats:italic>\n \u2009<\u20090.001), shorter procedural times (86.1\u2009\u00b1\u200947.2\u2009min vs. 103.0\u2009\u00b1\u200965.1\u2009min,\n p<\/jats:italic>\n \u2009<\u20090.001), lower contrast medium usage (104.0\u2009\u00b1\u200954.8\u2009mL vs. 126.0\u2009\u00b1\u200969.0\u2009mL,\n p<\/jats:italic>\n \u2009<\u20090.001), and shorter fluoroscopy times (25.9\u2009\u00b1\u200920.0\u2009min vs. 32.4\u2009\u00b1\u200926.9\u2009min,\n p<\/jats:italic>\n \u2009<\u20090.001). Additionally, the slender group experienced fewer complications, including procedure\u2010related myocardial infarction (odds ratio [OR] 1.25,\n p<\/jats:italic>\n \u2009=\u20090.004), cardiac tamponade (OR 1.52,\n p<\/jats:italic>\n \u2009=\u20090.048), heart failure or cardiogenic shock (OR 1.57,\n p<\/jats:italic>\n \u2009<\u20090.001), stent thrombosis (OR 2.42,\n p<\/jats:italic>\n \u2009=\u20090.02), emergency surgery (OR 3.45,\n p<\/jats:italic>\n \u2009=\u20090.02), and bleeding complications at both the access (OR 3.16,\n p<\/jats:italic>\n \u2009<\u20090.001) and non\u2010access sites (OR 1.94,\n p<\/jats:italic>\n \u2009=\u20090.02). Although the in\u2010hospital mortality rate was slightly lower in the slender group, this difference was not statistically significant (OR 1.11,\n p<\/jats:italic>\n \u2009=\u20090.39).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Slender PCI using a 5 Fr or smaller sheath was associated with a favorable safety profile, shorter procedural times, and fewer complications compared to larger sheath sizes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ccd.70140","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T13:06:50Z","timestamp":1756818410000},"page":"2844-2849","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Procedural Characteristics and Safety of Slender Percutaneous Coronary Intervention: Slender Is Better"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-3376","authenticated-orcid":false,"given":"Fuminobu","family":"Yoshimachi","sequence":"first","affiliation":[{"name":"Department of Cardiology Tokai University Hachioji Hospital Hachioji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyohei","family":"Yamaji","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kyoto University School of Medicine Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Kohsaka","sequence":"additional","affiliation":[{"name":"Department of Cardiology Keio University School of Medicine Shinjuku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yota","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokai University Hachioji Hospital Hachioji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kasai","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokai University Hachioji Hospital Hachioji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiharu","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokai University Hachioji Hospital Hachioji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Nagamatsu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokai University Hachioji Hospital Hachioji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazushige","family":"Amano","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokai University Hachioji Hospital Hachioji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Karasawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokai University Hachioji Hospital Hachioji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kita\u2010Harima Medical Center Ono Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihisa","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shiga University of Medical Science Otsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Ikari","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokai University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy394"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001038"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-20-1282"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-015-0344-2"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-16-00816"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26773"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2009.05.012"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-020-00669-z"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2013.11.021"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1522-726X(199902)46:2<173::AID-CCD12>3.0.CO;2-4"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.11.026"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002170"},{"issue":"1","key":"e_1_2_11_14_1","first-page":"16","article-title":"A Prospective Multicenter Study Using a Virtual 3 Fr Percutaneous Coronary Intervention System: The V3 Registry","volume":"29","author":"Yoshimachi F.","year":"2017","journal-title":"Journal of Invasive Cardiology"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T19:04:56Z","timestamp":1762283096000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,2]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/ccd.70140"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70140","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,2]]},"assertion":[{"value":"2025-05-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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