Carosio G, Taverna G, Ballestrero G, Reale M, Massa R, Ravazzi P A
Divisione di Cardiologia, Laboratorio di Emodinamica, Ospedale Civile, Alessandria.
G Ital Cardiol. 1991 Jul;21(7):725-30.
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.
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。
