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导引导管延长装置在严重钙化病变的肾血管成形术中有效。

Guide Catheter Extension Device Is Effective in Renal Angioplasty for Severely Calcified Lesions.

作者信息

Sugimoto Takeshi, Nomura Tetsuya, Hori Yusuke, Yoshioka Kenichi, Kubota Hiroshi, Miyawaki Daisuke, Urata Ryota, Kikai Masakazu, Keira Natsuya, Tatsumi Tetsuya

机构信息

Department of Cardiovascular Medicine, Nantan General Hospital, Kyoto, Japan.

出版信息

Am J Case Rep. 2017 May 23;18:568-572. doi: 10.12659/ajcr.903876.

DOI:10.12659/ajcr.903876
PMID:28533503
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5447664/
Abstract

BACKGROUND The GuideLiner catheter extension device is a monorail-type "Child" support catheter that facilitates coaxial alignment with the guide catheter and provides an appropriate back-up force. This device has been developed in the field of coronary intervention, and now is becoming widely applied in the field of endovascular treatment. However, there has been no report on the effectiveness of the guide catheter extension device in percutaneous transluminal renal angioplasty (PTRA). CASE REPORT We encountered a case of atherosclerotic subtotal occlusion at the ostium of the left renal artery. Due to the severely calcified orifice and weaker back-up force provided by a JR4 guide catheter, we could not pass any guidewires through the target lesion. Therefore, we introduced a guide catheter extension device, the GuideLiner catheter, through the guide catheter and achieved good guidewire maneuverability. We finally deployed 2 balloon-expandable stents and successfully performed all PTRA procedures. CONCLUSIONS The guide catheter extension device can be effective in PTRA for severely calcified subtotal occlusion.

摘要

背景

GuideLiner导管延长装置是一种单轨型“儿童”支撑导管，有助于与引导导管同轴对齐并提供适当的支撑力。该装置已在冠状动脉介入领域得到开发，目前正广泛应用于血管内治疗领域。然而，关于引导导管延长装置在经皮腔内肾血管成形术（PTRA）中的有效性尚无报道。病例报告：我们遇到一例左肾动脉开口处动脉粥样硬化性次全闭塞病例。由于严重钙化的开口以及JR4引导导管提供的支撑力较弱，我们无法使任何导丝穿过靶病变。因此，我们通过引导导管引入了一种引导导管延长装置，即GuideLiner导管，并实现了良好的导丝操控性。我们最终植入了2枚球囊扩张支架，并成功完成了所有PTRA操作。结论：引导导管延长装置在治疗严重钙化的次全闭塞性PTRA中可能有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cda/5447664/aebefc4976ea/amjcaserep-18-568-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cda/5447664/0d46e556b781/amjcaserep-18-568-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cda/5447664/e9ac77539b41/amjcaserep-18-568-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cda/5447664/2eaa7db4ddf5/amjcaserep-18-568-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cda/5447664/aebefc4976ea/amjcaserep-18-568-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cda/5447664/0d46e556b781/amjcaserep-18-568-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cda/5447664/e9ac77539b41/amjcaserep-18-568-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cda/5447664/2eaa7db4ddf5/amjcaserep-18-568-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cda/5447664/aebefc4976ea/amjcaserep-18-568-g004.jpg

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本文引用的文献

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Successful endovascular treatment with GuideLiner catheter of chronic aortic occlusion with severe calcification.
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2
Successful percutaneous coronary intervention with GuideLiner® catheter for subtotal occlusive lesion in the right coronary artery with anomalous origin from the left sinus of Valsalva: a case report.使用GuideLiner®导管成功进行经皮冠状动脉介入治疗：针对起源于左冠窦的异常右冠状动脉次全闭塞病变的病例报告
J Med Case Rep. 2015 Jul 28;9:163. doi: 10.1186/s13256-015-0646-0.
3
The management of renal artery stenosis: an alternative interpretation of ASTRAL and CORAL.肾动脉狭窄的管理：对ASTRAL和CORAL试验的另一种解读
Eur J Vasc Endovasc Surg. 2015 Apr;49(4):465-73. doi: 10.1016/j.ejvs.2014.12.026. Epub 2015 Feb 26.
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Stenting and medical therapy for atherosclerotic renal-artery stenosis.经皮腔内血管成形术及药物治疗动脉粥样硬化性肾动脉狭窄
N Engl J Med. 2014 Jan 2;370(1):13-22. doi: 10.1056/NEJMoa1310753. Epub 2013 Nov 18.
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Significant reduction in systolic blood pressure following renal artery stenting in patients with uncontrolled hypertension: results from the HERCULES trial.肾动脉支架置入术治疗未控制高血压患者的收缩压显著降低：HERCULES 试验结果。
Catheter Cardiovasc Interv. 2012 Sep 1;80(3):343-50. doi: 10.1002/ccd.24449. Epub 2012 Jun 27.
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The Guideliner™ catheter for stent delivery in difficult cases: tips and tricks.用于困难病例中支架输送的 Guideliner™ 导管：技巧与窍门。
J Interv Cardiol. 2011 Oct;24(5):450-61. doi: 10.1111/j.1540-8183.2011.00671.x.
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Distal stent delivery with Guideliner catheter: first in man experience.使用 Guideliner 导管输送远端支架：首例人体经验。
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