Gobeil François, Juneau Carl, Plante Sylvain
Quebec Heart Institute, Laval.
Can J Cardiol. 2002 Mar;18(3):263-9.
Various coatings are used on catheters and guide wires to improve resistance to surface thrombus formation. However, little is known about the thrombogenicity of 0.014" angioplasty guide wires and the protection offered by these coatings.
To evaluate the thrombogenicity of five different guide wires used in coronary angioplasty.
Five different 0.014" guide wire types were evaluated in 50 consecutive angioplasty procedures. At the end of the procedure, the distal part of the guide wire was cut, put in formalin and prepared for scanning electron microscopic evaluation. The condition of each guide wire was then classified into one of three predefined categories: no thrombus, limited thrombus and significant thrombus formation.
Silicone (n=10, Guidant, USA), phosphorylcholine polymer (n=8, Biocompatibles, Ireland), hydrophilic polymer (n=8, Scimed, USA) and two Teflon-based coatings (n=16, Schneider, USA; n=8, Cordis, USA) were evaluated. On microscopic examination, 48% of guide wires had a significant amount of thrombus, 18% had limited thrombus formation and 34% had no thrombus. The results were very dissimilar among the groups. Significant thrombus was found on 80% of Guidant guide wires, 69% of Schneider guide wires, 38% of Scimed guide wires and 25% of Cordis guide wires, while none was found on Biocompatibles guide wires (P<0.0001).
Significant thrombus formation on angioplasty guide wires was a frequent finding, occurring in 48% of cases. Resistance to thrombus formation was very dissimilar among coatings, with only the Biocompatibles phosphorylcholine-coated guide wires showing no thrombus formation at all. Whether subclinical thromboembolization occurred in some patients is unknown, and the clinical implications of this study remain to be defined.
导管和导丝上使用了各种涂层，以提高其抗表面血栓形成的能力。然而，对于0.014英寸血管成形术导丝的血栓形成倾向以及这些涂层所提供的保护作用，人们了解甚少。
评估用于冠状动脉成形术的五种不同导丝的血栓形成倾向。
在连续50例血管成形术操作中对五种不同类型的0.014英寸导丝进行评估。操作结束时，将导丝远端切断，放入福尔马林中，准备进行扫描电子显微镜评估。然后将每根导丝的情况分为三个预定义类别之一：无血栓、有限血栓形成和显著血栓形成。
对硅胶涂层导丝（n = 10，美国Guidant公司）、磷酰胆碱聚合物涂层导丝（n = 8，爱尔兰Biocompatibles公司）、亲水性聚合物涂层导丝（n = 8，美国Scimed公司）以及两种基于聚四氟乙烯的涂层导丝（n = 16，美国Schneider公司；n = 8，美国Cordis公司）进行了评估。显微镜检查显示，48%的导丝有大量血栓，18%的导丝有有限血栓形成，34%的导丝无血栓。各组结果差异很大。在Guidant导丝中有80%发现有显著血栓，Schneider导丝中有69%，Scimed导丝中有38%，Cordis导丝中有25%，而Biocompatibles导丝中未发现血栓（P<0.0001）。
血管成形术导丝上显著血栓形成是常见现象，在48%的病例中出现。不同涂层的抗血栓形成能力差异很大，只有Biocompatibles公司的磷酰胆碱涂层导丝完全没有血栓形成。尚不清楚一些患者是否发生了亚临床血栓栓塞，本研究的临床意义仍有待确定。
