Banovic Marko, Ostojic Miodrag C, Bartunek Jozef, Nedeljkovic Milan, Beleslin Branko, Terzic Andre
Department of Cardiology, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Tex Heart Inst J. 2011;38(2):179-82.
Several methods are available for delivering stem cells to the heart. Recent studies have highlighted the advantages of injecting the cells directly into the myocardium in order to increase myocardial retention of cells. A particular focus has been on percutaneous transendocardial injection, facilitated by electromechanical mapping.The NOGA XP Cardiac Navigation System has a multicomponent catheter that is designed to guide and deliver transendocardial injections via a transfemoral approach, without a guidewire. However, this method may not be feasible in some patients who have peripheral vascular disease. Herein, we describe the case of a 68-year-old man whose tortuous, sharply angled iliac arteries precluded a femoral approach to transendocardial injection. To overcome the anatomic and mechanical challenges, we used a brachial approach. We believe that this is the 1st report of using the brachial route for transendocardial injection, and that it can be a viable alternative to the transfemoral approach in selected patients.
有几种方法可用于将干细胞输送到心脏。最近的研究强调了将细胞直接注射到心肌中以增加细胞在心肌中的留存率的优势。特别关注的是经皮经心内膜注射，这借助于机电标测得以实现。NOGA XP心脏导航系统有一个多组件导管，其设计目的是通过经股动脉途径在没有导丝的情况下引导并进行经心内膜注射。然而，这种方法在一些患有外周血管疾病的患者中可能不可行。在此，我们描述了一名68岁男性的病例，其髂动脉迂曲且角度尖锐，排除了经股动脉途径进行经心内膜注射的可能性。为克服解剖和机械方面的挑战，我们采用了经肱动脉途径。我们认为这是首次关于使用经肱动脉途径进行经心内膜注射的报告，并且在选定的患者中它可以成为经股动脉途径的可行替代方法。
