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5F导管在经皮股动脉冠状动脉-心室造影中的应用(5F导管连续500例操作)

[Use of 5 French catheters in percutaneous femoral coronaro-ventriculography (500 consecutive procedures with 5 French catheters)].

作者信息

Carosio G, Taverna G, Ballestrero G, Reale M, Massa R, Ravazzi P A

机构信息

Divisione di Cardiologia, Laboratorio di Emodinamica, Ospedale Civile, Alessandria.

出版信息

G Ital Cardiol. 1991 Jul;21(7):725-30.

PMID:1765232
Abstract

To verify the advantages and the systematic use of 5 French catheters in femoral percutaneous coronaroventriculography, 500 consecutive unselected patients with confirmed or suspected coronary artery disease underwent this procedure. In one case only (0.2%) we had recourse to 7 French catheters on account of the inability to enter the left coronary ostium. There were no major local complications. General complications were represented by vagal reactions in 20 cases (4%) and by transient minor motor aphasia in one case (0.2%). The cardiac complications were represented by: -1 (0.2%) atrio-ventricular isorhythmic dissociation; -1 (0.2%) complete right bundle branch block; -3 (0.6%) atrial fibrillation; (all had a rapid and spontaneous regression) -1 (0.2%) ventricular fibrillation treated successfully with D.C. shock; -1 (0.2%) non fatal acute myocardial infarction (at the end of the procedure); -2 (0.4%) attacks of cardiac asthma treated successfully with medical therapy. 5 French catheters have proved to be extremely efficacious, with some technical experience, in percutaneous coronaroventriculography via femoral approach. The possible advantages could consist of a reduction in local complications, a patient's precocious mobilization and a minor traumatism on the arterial wall. The major complications are comparable with those observed using 7-8 French catheters. In the future it might be possible, in selected patients, to use 5 French catheters to perform ambulatory cardiac catheterization with reduction of both costs and hospitalization period.

摘要

为验证5F导管在股动脉途径经皮冠状动脉造影术中的优势及系统应用,500例未经选择的确诊或疑似冠心病患者接受了该操作。仅1例(0.2%)因无法进入左冠状动脉口而使用了7F导管。无严重局部并发症。全身并发症表现为20例(4%)迷走神经反应和1例(0.2%)短暂性轻度运动性失语。心脏并发症表现为:- 1例(0.2%)房室等律分离;- 1例(0.2%)完全性右束支传导阻滞;- 3例(0.6%)心房颤动(均迅速自发恢复);- 1例(0.2%)心室颤动经直流电除颤成功治疗;- 1例(0.2%)非致命性急性心肌梗死(在操作结束时);- 2例(0.4%)心源性哮喘发作经药物治疗成功。5F导管经股动脉途径进行经皮冠状动脉造影术,在具备一定技术经验的情况下已被证明极其有效。其可能的优势包括减少局部并发症、患者更早活动以及对动脉壁的轻微创伤。主要并发症与使用7 - 8F导管观察到的并发症相当。未来,在特定患者中,使用5F导管进行动态心脏导管检查可能既降低成本又缩短住院时间。

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