Ma Jianying, Hou Lei, Qian Juying, Ge Lei, Zhang Feng, Chang Shufu, Xu Rende, Qin Qing, Ge Junbo
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Medicine (Baltimore). 2017 Oct;96(40):e8172. doi: 10.1097/MD.0000000000008172.
The monorail Guidezilla guide extension catheter was designed to provide additional backup and facilitate device delivery in percutaneous coronary intervention (PCI) for complex coronary anatomy such as chronic total occlusion (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries, among others.The present retrospective, single-center study included 188 consecutive patients who underwent PCI using the Guidezilla catheter from March 2015 to August 2016. Study outcomes were rates of target lesion crossing success, procedural success, and complications.The Guidezilla catheter was used most commonly in PCI of CTOs (45%) and heavy proximal calcification (37%), followed by tortuosity (10%), previously deployed proximal stents (4%), and coronary artery anomaly (4%). The right coronary artery (48%) was most commonly intervened followed by the left ascending (35%) and left circumflex (17%) arteries. Rates of target lesion crossing success and procedural success were both 99%, with one device-related periprocedural complication, namely proximal vessel dissection secondary to deep insertion which was successfully treated with stent implantation. Ninety percent of PCI were performed and completed successfully by radial access.In a single center with experienced operators, the use of the Guidezilla guide extension catheter in PCI of complex coronary anatomy performed mostly via radial artery access appeared safe and efficacious, and greatly facilitated device delivery.
单轨“导龙”（Guidezilla）导引导管旨在为复杂冠状动脉解剖结构（如慢性完全闭塞病变（CTO）、血管极度迂曲、病变的旁路移植血管和冠状动脉异常等）的经皮冠状动脉介入治疗（PCI）提供额外的支撑，并便于器械输送。本回顾性单中心研究纳入了2015年3月至2016年8月期间连续188例使用“导龙”导管进行PCI的患者。研究结局指标为靶病变通过成功率、手术成功率和并发症发生率。“导龙”导管最常用于CTO病变（45%）和近端严重钙化（37%）的PCI，其次是血管迂曲（10%）、先前植入的近端支架（4%）和冠状动脉异常（4%）。最常干预的是右冠状动脉（48%），其次是左前降支（35%）和左旋支（17%）。靶病变通过成功率和手术成功率均为99%，有1例与器械相关的围手术期并发症，即因深插入导致的近端血管夹层，通过支架植入成功治疗。90%的PCI通过桡动脉途径成功完成。在一个由经验丰富的术者组成的单中心，在主要经桡动脉途径进行的复杂冠状动脉解剖结构的PCI中使用“导龙”导引导管似乎是安全有效的，并且极大地便于器械输送。
