Villavicencio R, Urban P, Muller T, Favre J, Meier B
Cardiology Center, University Hospital, Geneva, Switzerland.
Cathet Cardiovasc Diagn. 1991 Jan;22(1):56-9. doi: 10.1002/ccd.1810220114.
We investigated the use of ultralow profile balloon catheters (Scimed ACE, USCI Probe, Cordis, Orion) for coronary angioplasty through 6 French diagnostic catheters (Schneider, Cordis). Contrast injection was assisted with a Hercules pump (Cordis) in all cases. During 21 procedures, angioplasty of 27 lesions in 20 selected patients was attempted (1.3 lesion/procedure). Twelve lesions were in the right, 10 in the left anterior descending, and 5 in the left circumflex coronary artery. Balloon size varied between 2.5 and 3.5 mm. Twenty lesions could be successfully dilated (74%) through the 6 French catheter and 7 lesions required an exchange to a 7 French angioplasty guiding catheter. For 5 cases, another balloon was also necessary to complete the procedure. The final overall success rate was 100% per patient and per lesion and there were no major complications. Despite the small internal catheter lumen (1.22 mm) coronary visualization was adequate, and mechanical support was good. Failures of 6 French catheters were attributed to insufficient torque control and excessive friction when the balloon crossed the tapered end of the diagnostic catheter. Coronary angioplasty through a diagnostic 6 French catheter is feasible and may represent a reasonable alternative for simple cases that are done during the same session as the diagnostic angiography. Once available, 6 French high flow angioplasty guiding catheters without a tapered tip should improve success while retaining the advantage of a small femoral puncture site.
我们研究了通过6F诊断导管（施奈德、科迪斯）使用超薄型球囊导管（Scimed ACE、USCI Probe、科迪斯、猎户座）进行冠状动脉血管成形术的情况。所有病例均使用大力神泵（科迪斯）辅助注射造影剂。在21例手术中，尝试对20例选定患者的27处病变进行血管成形术（1.3处病变/手术）。12处病变位于右冠状动脉，10处位于左前降支，5处位于左旋支冠状动脉。球囊尺寸在2.5至3.5毫米之间。20处病变可通过6F导管成功扩张（74%），7处病变需要更换为7F血管成形术引导导管。5例患者还需要使用另一个球囊来完成手术。最终每位患者和每处病变的总体成功率均为100%，且无重大并发症。尽管导管内腔较小（1.22毫米），但冠状动脉显影良好，机械支撑也不错。6F导管的失败归因于球囊穿过诊断导管锥形末端时扭矩控制不足和摩擦力过大。通过6F诊断导管进行冠状动脉血管成形术是可行的，对于与诊断性血管造影在同一时段进行的简单病例而言，可能是一种合理的选择。一旦有了无锥形尖端的6F高流量血管成形术引导导管，成功率将会提高，同时保留股动脉穿刺部位小的优势。
