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使用无鞘标准引导导管经桡动脉进行经皮冠状动脉介入治疗分叉病变。

Using sheathless standard guiding catheters for transradial percutaneous coronary intervention to treat bifurcation lesions.

作者信息

Li Qiyong, He Yong, Jiang Rongjian, Huang Dejia

机构信息

Department of Cardiology, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Science, Chengdu, China.

出版信息

Exp Clin Cardiol. 2013 Spring;18(2):73-6.

Abstract

OBJECTIVE

To investigate the feasibility and safety of using sheathless standard guiding catheters for transradial percutaneous coronary intervention (PCI) to treat bifurcation lesions.

METHODS

Coronary bifurcation lesions were identified using angiography in 43 patients with coronary artery disease. These patients underwent transradial PCI using sheathless standard guiding catheters, and the procedural success and complication rates were recorded.

RESULTS

All 43 patients underwent successful PCI. The Culotte stenting technique was used in 22 (51.2%) subjects, the Crush stenting technique was used in eight (18.8%) subjects and the crossover stenting implantation technique was used in 13 (30.0%) subjects. Of the 43 coronary artery bifurcation lesions, the final kissing balloon technique was performed in 39 (90.1%) lesions. Adjunctive devices used in the cohort included intravascular ultrasound for 32 (74.4%) patients, thrombus aspiration catheters for two patients and cutting balloon for five patients. During the perioperative period, no major complications associated with vessel puncture or adverse cardiac or cerebrovascular events occurred in any of the 43 patients enrolled in the present study. At day 30, radial artery occlusion was detected in only three (2.5%) patients and radial artery stenosis in four (9.3%) patients. At six-month follow-up, 24 (55.8%) patients exhibited coronary artery patency with no significant intimal hyperplasia.

CONCLUSIONS

Transradial PCI using the sheathless technique may be a feasible and safe technique to treat coronary bifurcation lesions.

摘要

目的

探讨使用无鞘标准引导导管经桡动脉行冠状动脉介入治疗(PCI)治疗分叉病变的可行性和安全性。

方法

对43例冠心病患者行血管造影以识别冠状动脉分叉病变。这些患者使用无鞘标准引导导管行经桡动脉PCI,并记录手术成功率和并发症发生率。

结果

43例患者均成功完成PCI。采用Culotte支架置入技术的患者有22例(51.2%),采用Crush支架置入技术的患者有8例(18.8%),采用交叉支架置入技术的患者有13例(30.0%)。在43处冠状动脉分叉病变中,39处病变(90.1%)采用了最终球囊对吻技术。该队列中使用的辅助设备包括32例患者(74.4%)使用血管内超声、2例患者使用血栓抽吸导管、5例患者使用切割球囊。在围手术期,本研究纳入的43例患者中无一例发生与血管穿刺相关的重大并发症或不良心脑血管事件。在第30天时,仅3例(2.5%)患者检测到桡动脉闭塞,4例(9.3%)患者检测到桡动脉狭窄。在6个月随访时,24例(55.8%)患者冠状动脉通畅,无明显内膜增生。

结论

使用无鞘技术经桡动脉PCI可能是治疗冠状动脉分叉病变的一种可行且安全的技术。

相似文献

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Sheathless transradial intervention using standard guide catheters.无鞘径路经桡动脉介入治疗使用标准导引导管。
Catheter Cardiovasc Interv. 2010 Dec 1;76(7):911-6. doi: 10.1002/ccd.22742. Epub 2010 Oct 7.

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