Schöbel W A, Spyridopoulos I, Hoffmeister H M, Seipel L
Department of Cardiology, University of Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, Germany.
Catheter Cardiovasc Interv. 2001 Jul;53(3):308-12. doi: 10.1002/ccd.1172.
The aim of this prospective study was to analyze the technical feasibility, the success rate, and the special complications of percutaneous coronary interventions (PCIs) using a newly released 5 Fr guiding catheter with an inner diameter of 0.058". The study was performed in 150 consecutive patients subjected to coronary angioplasty. In 89% of the patients, the intervention was started with a 5 Fr catheter (JR4 or JL4); in 16 patients a 6 or 7 Fr catheter was used because of unstable clinical conditions according to the decision of the interventional cardiologist. In 12 out of 134 patients, the guiding catheter had to be changed during the intervention from 5 Fr to a 6 or 7 Fr catheter due to poor backup support. In 112 out of 118 patients, the intervention was successfully performed using a 5 Fr catheter (95%); in 12 out of 16 patients, after changing the guiding catheter, the overall success rate was 93%. In patients with type A and B lesions who were initially treated using a 5 Fr catheter, the procedural success rate was 100% (81 out of 81), whereas in patients with type C lesions the procedural success rate was 83% (43 out of 53; P = 0.000053, Fisher's exact test). Furthermore, in patients with a diameter stenosis < 90%, the procedural success rate was 100% (57 out of 57), whereas in patients with a diameter stenosis of 90%-100%, the procedural success rate was 87% (67 out of 77; P = 0.0050). Stent implantation was performed successfully in 24 patients (18%) using the 5 Fr guiding catheter. This study confirms that PCI was technically feasible using a 5 Fr guiding catheter in the majority of consecutive patients with a success rate of 95%. There were significant differences in the success rate depending on the lesion type and the diameter stenosis. Complications were very rare and were not related to the guiding catheter. Limitations of the 5 Fr guiding catheters arose mainly from a poor backup support in long lesions and severe stenosis. Cathet Cardiovasc Intervent 2001;53:308-312.
这项前瞻性研究的目的是分析使用一种新推出的内径为0.058英寸的5F引导导管进行经皮冠状动脉介入治疗（PCI）的技术可行性、成功率及特殊并发症。该研究在150例接受冠状动脉血管成形术的连续患者中进行。89%的患者以5F导管（JR4或JL4）开始介入治疗；16例患者因介入心脏病专家根据临床不稳定情况决定使用6F或7F导管。134例患者中有12例在介入过程中因支撑不足不得不将引导导管从5F更换为6F或7F导管。118例患者中有112例（95%）使用5F导管成功完成介入治疗；16例患者中有12例在更换引导导管后总体成功率为93%。最初使用5F导管治疗的A、B型病变患者手术成功率为100%（81例中的81例），而C型病变患者手术成功率为83%（53例中的43例；P = 0.000053，Fisher精确检验）。此外，直径狭窄<90%的患者手术成功率为100%（57例中的57例），而直径狭窄为90%-100%的患者手术成功率为87%（77例中的67例；P = 0.0050）。使用5F引导导管成功为24例患者（18%）植入支架。本研究证实，在大多数连续患者中使用5F引导导管进行PCI在技术上是可行的，成功率为95%。成功率因病变类型和直径狭窄程度存在显著差异。并发症非常罕见且与引导导管无关。5F引导导管的局限性主要源于长病变和严重狭窄时支撑不足。《心血管介入导管杂志》2001年；53:308 - 312。
