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一种使用手动血栓切除术导管输送Filtrap冠状动脉栓塞保护过滤器的新方法:与传统方法的体外和体内比较。

A novel method to deliver the Filtrap coronary embolic protection filter using a manual thrombectomy catheter: in vitro and in vivo comparison with the conventional method.

作者信息

Watanabe Shin, Saito Naritatsu, Tokushige Akihiro, Bingyuan Bao, Kawase Yoshiaki, Kimura Takeshi

机构信息

Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.

出版信息

J Invasive Cardiol. 2012 Apr;24(4):159-63.

Abstract

BACKGROUND

Although several types of distal embolic protection devices have been developed, they are usually difficult to use because of their stiff and bulky characteristics. We present a novel method to deliver the coronary embolic protection filter via a manual thrombectomy catheter.

METHODS

We modified the Filtrap embolic protection filter (Nipro Corporation) to pass through the aspiration thrombectomy catheter. Three interventional cardiologists performed the Filtrap delivery with in vivo and in vitro coronary arteries using two different methods. The in vitro experiments were performed using a Circuit Cardiac Catheterization Simulator (Just Medical Corporation) with and without coronary artery stenosis. The in vivo experiment was performed using a normal pig coronary artery. The times required for Filtrap delivery in the two different methods were compared. The target lesions were the main and side branch of the left anterior descending, left circumflex, and right coronary arteries.

RESULTS

The average Filtrap delivery time when using the thrombectomy catheter was significantly shorter compared to the time using the conventional method (in vitro experiment without coronary stenosis, 39 ± 14 seconds vs 30 ± 6 seconds and P=.019; in vitro experiment with multiple coronary stenosis, 69 ± 55 seconds vs 32 ± 11 seconds and P=.012; in vivo experiment, 169 ± 166 seconds vs 51 ± 12 seconds; P=.019).

CONCLUSION

The study results indicate that delivery of the coronary embolic protection filter via a manual thrombectomy catheter may simplify the procedure and decrease the procedure time.

摘要

背景

尽管已研发出几种类型的远端栓塞保护装置,但由于其僵硬和笨重的特性,通常难以使用。我们提出了一种通过手动血栓切除术导管输送冠状动脉栓塞保护过滤器的新方法。

方法

我们对Filtrap栓塞保护过滤器(日医工株式会社)进行了改良,使其能够通过抽吸血栓切除术导管。三名介入心脏病学家使用两种不同方法在体内和体外冠状动脉中进行Filtrap输送。体外实验使用了带有和不带有冠状动脉狭窄的电路心脏导管插入模拟器(Just Medical Corporation)。体内实验使用正常猪的冠状动脉进行。比较了两种不同方法中Filtrap输送所需的时间。目标病变为左前降支、左旋支和右冠状动脉的主支和分支。

结果

与使用传统方法相比,使用血栓切除术导管时Filtrap的平均输送时间明显更短(体外无冠状动脉狭窄实验,39±14秒对30±6秒,P = 0.019;体外多冠状动脉狭窄实验,69±55秒对32±11秒,P = 0.012;体内实验,169±166秒对51±12秒;P = 0.019)。

结论

研究结果表明,通过手动血栓切除术导管输送冠状动脉栓塞保护过滤器可能会简化操作并缩短操作时间。

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