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磁导航与传统导丝技术行经皮冠状动脉介入治疗的比较。

Primary percutaneous coronary intervention by magnetic navigation compared with conventional wire technique.

机构信息

Amsterdam Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, Amsterdam, The Netherlands.

出版信息

Eur Heart J. 2011 Jun;32(12):1472-8. doi: 10.1093/eurheartj/ehp587. Epub 2010 Jan 4.

Abstract

Aims Comparison of magnetic guidewire navigation in percutaneous coronary intervention (MPCI) vs. conventional percutaneous coronary intervention (CPCI) for the treatment of acute myocardial infarction. Methods and results We compared 65 sequential patients (mean age 61 ± 15 years) undergoing primary MPCI with those of 405 patients undergoing CPCI (mean age 61 ± 13 years). The major endpoint was contrast media use. Technical success and procedural outcomes were evaluated. Clinical demographics and angiographic characteristics of the two groups were similar, except for fewer patients with previous coronary artery bypass grafting (CABG) and hypertension in the CPCI group and fewer patients with diabetes in the MPCI group. The technical success rate was high in both the MPCI and CPCI groups (95.4 vs. 98%). There was significantly less contrast media usage in the MPCI compared with the CPCI group, median reduction of contrast media of 30 mL with an OR = 0.41 (0.21-0.81). Fluoroscopy times were significantly reduced for MPCI compared with CPCI, median reduction of 7.2 min with an OR = 0.42 (0.20-0.79). Conclusion This comparison indicates the feasibility and non-inferiority of magnetic navigation in performing primary PCI and suggests the possibility of reductions in contrast media use and fluoroscopy time compared with CPCI.

摘要

目的 比较经皮冠状动脉介入治疗(PCI)中使用磁导航导丝(MPCI)与传统 PCI(CPCI)治疗急性心肌梗死的效果。

方法和结果 我们比较了 65 例连续接受直接 MPCI 治疗的患者(平均年龄 61 ± 15 岁)与 405 例接受 CPCI 治疗的患者(平均年龄 61 ± 13 岁)。主要终点是对比剂的使用。评估了技术成功率和程序结果。两组的临床人口统计学和血管造影特征相似,但 CPCI 组接受过冠状动脉旁路移植术(CABG)和高血压治疗的患者较少,MPCI 组接受过糖尿病治疗的患者较少。两组的技术成功率均较高(MPCI 组为 95.4%,CPCI 组为 98%)。与 CPCI 组相比,MPCI 组使用的对比剂明显较少,中位数减少 30ml,比值比(OR)为 0.41(0.21-0.81)。与 CPCI 相比,MPCI 的透视时间明显减少,中位数减少 7.2 分钟,比值比(OR)为 0.42(0.20-0.79)。

结论 该比较表明在进行直接 PCI 时使用磁导航是可行且非劣效的,并提示与 CPCI 相比,可能减少对比剂的使用和透视时间。

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