Villavicencio R, Meier B, Pande A K, Urban P, Sztajzel J, de la Serna F
Cardiology Center, University Hospital, Geneva, Switzerland.
Am Heart J. 1991 Dec;122(6):1519-21. doi: 10.1016/0002-8703(91)90266-k.
The performance of 7F guiding catheters for percutaneous transluminal coronary angioplasty (PTCA) was investigated in 300 patients. A total of 233 patients had single-vessel PTCA and 67 had multivessel PTCA. Angioplasty was attempted for 371 lesions (141 [38%] in the left anterior descending, 124 [33%] in the right coronary artery, and 95 [26%] in the left circumflex coronary artery or their branches; 10 [3%] in a bypass graft, and one in the left main stem). The mean degree of stenosis was 86 +/- 11% (range 60% to 100%). The monorail technique was used in 83%, and balloon-on-a-wire devices were used in 6% of cases. The balloon sizes varied between 2.0 and 4.25 mm. There was a 98% technical success rate for the 325 nontotal lesions. Five could not be crossed with the wire. Exchange to an 8F guiding catheter was done in four cases (1.2%) and yielded success in two of them. In 46 occlusions the success rate was 72%. Nine were failures due to an inability to cross the wire, another two were balloon failures, and in two cases the residual stenosis was greater than 50%. The mean residual stenosis of successful cases was 24 +/- 18%. Overall, the primary success rate was 95%. The complications were: in-hospital death in five patients (1.7%); infarction in 12 (4%); emergency bypass surgery in one; and significant inguinal hematoma in five (1.7%). Coronary angioplasty through 7F guiding catheters yields a high success rate with less coronary wedging and a smaller puncture hole.
在300例患者中研究了7F引导导管用于经皮腔内冠状动脉成形术（PTCA）的性能。共有233例患者接受单支血管PTCA，67例接受多支血管PTCA。对371处病变尝试进行血管成形术（左前降支141处[38%]，右冠状动脉124处[33%]，左旋支冠状动脉或其分支95处[26%]；旁路移植血管10处[3%]，左主干1处）。平均狭窄程度为86±11%（范围60%至100%）。83%的病例采用单轨技术，6%的病例使用球囊导丝装置。球囊大小在2.0至4.25mm之间变化。325处非完全闭塞病变的技术成功率为98%。5处病变导丝无法通过。4例（1.2%）更换为8F引导导管，其中2例成功。46处闭塞病变的成功率为72%。9例因导丝无法通过而失败，另外2例球囊扩张失败，2例残余狭窄大于50%。成功病例的平均残余狭窄为24±18%。总体而言，初次成功率为95%。并发症包括：5例患者（1.7%）住院死亡；12例（4%）发生梗死；1例进行急诊旁路手术；5例（1.7%）出现明显的腹股沟血肿。通过7F引导导管进行冠状动脉成形术成功率高，冠状动脉楔入较少，穿刺孔较小。
