Pande A K, Meier B, Urban P, Villavicencio R, de la Serna F, Moles V
Cardiology Center, University Hospital, Geneva, Switzerland.
Int J Cardiol. 1991 Jul;32(1):23-7. doi: 10.1016/0167-5273(91)90040-v.
The Monorail system (Schneider) consists of a balloon catheter in which the guidewire passes through the balloon itself, exits the catheter proximal to the balloon, and runs alongside its small shaft (3 French) through the length of the guiding catheter. It offers distinct advantages over conventional systems of coronary angioplasty. It facilitates contrast injections and permits rapid balloon exchanges. This system was used for coronary angioplasty in 273 unselected consecutive patients (age 59 +/- 10, mean 35 to 73 years). There were 216 patients (84%) undergoing single-vessel and 57 patients (16%) with multi-vessel coronary angioplasty. A total of 335 coronary stenoses were dilated, which included 35 total occlusions. The size of balloon used ranged from 2.0 to 4.25 mm (3.0 +/- 0.5 mm) and the severity of stenosis was 85 +/- 11%. Technical success was defined as a residual stenosis of less than 50% as determined angiographically. Clinical success was defined as technical success, and absence of a major inhospital complication defined as absence of myocardial infarction, lack of need for coronary arterial bypass surgery, and survival. The Monorail system was technically successful in 294/300 stenotic lesions (98%). It was clinically successful for 281 lesions (94%). Of the 35 total occlusions, technical success was obtained in 25 (71%). The residual stenosis of successful cases was 26 +/- 21%. The Monorail system was also successful in 5 patients with stenosis of more than 90% in whom conventional systems failed. The complications included acute occlusion causing acute myocardial infarction in 13 cases (5%), emergency coronary arterial bypass surgery in 1 patient (0.4%), and death in 4 patients (1.5%).(ABSTRACT TRUNCATED AT 250 WORDS)
单轨系统（施奈德公司生产）由一个球囊导管组成，导丝穿过球囊本身，在球囊近端穿出导管，并沿着其细轴（3法）贯穿引导导管的全长。与传统的冠状动脉成形术系统相比，它具有明显的优势。它便于注射造影剂，并允许快速更换球囊。该系统用于对273例未经挑选的连续患者（年龄59±10岁，平均35至73岁）进行冠状动脉成形术。其中216例患者（84%）接受单支血管冠状动脉成形术，57例患者（16%）接受多支血管冠状动脉成形术。共扩张了335处冠状动脉狭窄，其中包括35处完全闭塞病变。所用球囊的大小范围为2.0至4.25毫米（3.0±0.5毫米），狭窄程度为85±11%。技术成功定义为血管造影显示残余狭窄小于50%。临床成功定义为技术成功，且无主要的院内并发症，主要的院内并发症定义为无心肌梗死、无需冠状动脉搭桥手术且存活。单轨系统在294/300处狭窄病变中技术成功（98%）。281处病变临床成功（94%）。在35处完全闭塞病变中，25处（71%）技术成功。成功病例的残余狭窄为26±21%。单轨系统在5例传统系统失败的90%以上狭窄患者中也取得了成功。并发症包括13例（5%）因急性闭塞导致急性心肌梗死、1例患者（0.4%）进行急诊冠状动脉搭桥手术以及4例患者（1.5%）死亡。（摘要截选至250字）
