Serajian Asif
Department of Cardiology, West Suburban Medical Center, Oak Park, IL, USA.
J Invasive Cardiol. 2012 Feb;24(2):E30-1.
We report a case of GuideLiner catheter use during transradial intervention for selective coronary angiography of the distal left anterior descending artery (LAD), beyond the left internal mammary artery (LIMA) anastomosis. The lesion within the LAD was located distal to the anastomosis of a very tortuous LIMA, otherwise unable to be visualized due to competitive flow from the LIMA. Stenting by way of the LIMA could not be performed due to this severe tortuosity as well. Alternatively, performance of the intervention without GuideLiner assistance would have required dual access, with injections both through the LIMA graft and the native LAD for angiography and intervention. Use of the GuideLiner served the purpose of selective LAD angiography to visualize the lesion, as well as delivery of the stent through a proximally calcified LAD. Using this single transradial route allowed the intervention to be completed, while reducing complications due to multiple access sites.
我们报告了1例在经桡动脉介入治疗中使用Guideliner导管的病例，该介入治疗用于对左前降支（LAD）远端进行选择性冠状动脉造影，该部位位于左乳内动脉（LIMA）吻合口以远。LAD内的病变位于一支极度迂曲的LIMA吻合口以远，由于来自LIMA的竞争性血流，否则无法显影。由于这种严重的迂曲，也无法通过LIMA进行支架置入。另外，如果没有Guideliner辅助进行介入操作，则需要采用双入路，即通过LIMA移植物和自身LAD同时注射造影剂以进行血管造影和介入操作。使用Guideliner导管有助于对LAD进行选择性血管造影以显示病变，同时也有助于通过近端钙化的LAD输送支架。采用这种经桡动脉单入路使介入操作得以完成，同时减少了因多个入路部位导致的并发症。
