经皮冠状动脉介入治疗的磁导航系统：一项荟萃分析。

Magnetic navigation system for percutaneous coronary intervention: A meta-analysis.

作者信息

Qi Zhiyong, Wu Bangwei, Luo Xinping, Zhu Jun, Shi Haiming, Jin Bo

机构信息

Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Medicine (Baltimore). 2016 Jul;95(29):e4216. doi: 10.1097/MD.0000000000004216.

DOI:10.1097/MD.0000000000004216

PMID:27442645

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5265762/

Abstract

BACKGROUND

Magnetic navigation system (MNS) allows calculation of the vessel coordinates in real space within the patient's chest for percutaneous coronary intervention (PCI). However, its impact on the procedural parameters and clinical outcomes is still a matter of debate. To derive a more precise estimation of the relationship, a meta-analysis was performed.

METHODS AND RESULTS

Studies exploring the advantages of MNS were identified in English-language articles by search of Medline, Web of Science, and Cochrane Library Databases (inception to October 2015). A standardized protocol was used to extract details on study design, region origin, demographic data, lesion type, and clinical outcomes. The main outcome measures were contrast consumption, procedural success rate, contrast used for wire crossing, procedure time to cross the lesions, and the fluoroscopy time fluoroscopy time. A total of 12 clinical trials involving 2174 patients were included for analysis (902 patients in the magnetic PCI group and 1272 in the conventional PCI group). Overall, contrast consumption was decreased by 40.45 mL (95% confidence interval [CI] -70.98 to -9.92, P = 0.009) in magnetic PCI group compared with control group. In addition, magnetic PCI was associated with significantly decreasing procedural time by 2.17 minutes (95% CI -3.91 to -0.44, P = 0.01) and the total fluoroscopy time was significantly decreased by 1.43 minutes (95% CI -2.29 to -0.57, P = 0.001) in magnetic PCI group. However, procedural success rate, contrast used for wire crossing, procedure time to cross the lesions, and the fluoroscopy time to cross the lesions demonstrated that no statistically difference was observed between 2 groups.

CONCLUSION

The present meta-analysis indicated an improvement of overall contrast consumption, total procedural time, and fluoroscopy time in magnetic PCI group. However, no significant advantages were observed associated with procedural success rate.

摘要

背景

磁导航系统（MNS）可在患者胸部的真实空间内计算血管坐标，用于经皮冠状动脉介入治疗（PCI）。然而，其对手术参数和临床结果的影响仍存在争议。为了更精确地估计这种关系，我们进行了一项荟萃分析。

方法与结果

通过检索Medline、科学网和考克兰图书馆数据库（截至2015年10月），从英文文章中筛选出探讨MNS优势的研究。采用标准化方案提取研究设计、地区来源、人口统计学数据、病变类型和临床结果等详细信息。主要结局指标为造影剂用量、手术成功率、导丝通过时使用的造影剂、穿过病变的手术时间以及透视时间。共纳入12项临床试验，涉及2174例患者进行分析（磁导航PCI组902例患者，传统PCI组1272例患者）。总体而言，与对照组相比，磁导航PCI组的造影剂用量减少了40.45毫升（95%置信区间[CI] -70.98至-9.92，P = 0.009）。此外，磁导航PCI组的手术时间显著缩短2.17分钟（95% CI -3.91至-0.44，P = 0.01），总透视时间显著缩短1.43分钟（95% CI -2.29至-0.57，P = 0.001）。然而，手术成功率、导丝通过时使用的造影剂、穿过病变的手术时间以及穿过病变的透视时间显示，两组之间未观察到统计学差异。