Balaban Yakup
Vm Medical Park Kocaeli Hospital, Department of Cardiology, Başiskele, Kocaeli, Turkey.
J Interv Cardiol. 2018 Feb;31(1):94-105. doi: 10.1111/joic.12454. Epub 2017 Oct 11.
The incidence and severity of carotid atherosclerosis increases in proportion with coronary artery disease and its severity. A special catheter specifically used for transradial carotid angiography has not yet been marketed. In this study, we investigate the feasibility and safety of our carotid catheter, which was made by reshaping currently available catheters.
Between 2010 and 2017, a total of 921 patients with indications for carotid angiography were identified after angiographic examinations and included in the study. Carotid angiography was performed in 403 patients (female, n = 161) using the 3.5 JL catheter, while in 518 (female, n = 207) patients, new catheters were employed. The new catheter was shaped like a hook in the laboratory with a heat gun. Demographic information and angiographic data from the patients in both groups were retrospectively analyzed.
The baseline characteristics of both groups were comparable. When compared with the use of a 3.5 JL catheter, right transradial carotid angiographies performed with our new handmade catheter resulted in lesser amounts of opaque material used (55 mL vs 66 mL, P < 0.001) and shorter total fluoroscopy time, (3.60 ± 1.85 min vs 3.14 ± 1.55 min, P < 0.001). The handmade catheter also resulted in a higher success rate of selective visualization (97% vs 40%, P < 0.001). Rates of minor complication were comparable between the two catheters (6.5% vs 6.6% P = 234). Neither permanent damage nor morbidity or mortality was observed in either arm.
Currently available catheters and methods are inadequate for routine transradial carotid angiography. For routine transradial carotid angiography, innovatively designed catheters are required. The catheter we developed for transradial carotid angiography was more successful than the conventional catheter in obtaining satisfactory images. High quality images can be obtained with the newly designed catheters.
Transradial carotid angiography can be performed using our newly developed carotid catheter. The carotid arteries of patients with widespread coronary artery disease can be visualized, while asymptomatic patients carrying a high risk of stroke can be treated, preventing potential stroke occurrence. In a larger-scale comparative study, the favorable contributions of routine use of the new method and a decreased frequency of stroke may be demonstrated.
颈动脉粥样硬化的发病率和严重程度与冠状动脉疾病及其严重程度成正比。一种专门用于经桡动脉颈动脉血管造影的特殊导管尚未上市。在本研究中，我们调查了通过改造现有导管制成的颈动脉导管的可行性和安全性。
2010年至2017年期间，在血管造影检查后共确定了921例有颈动脉血管造影指征的患者并纳入研究。403例患者（女性161例）使用3.5 JL导管进行颈动脉血管造影，而518例患者（女性207例）使用新导管。新导管在实验室用热风枪制成钩状。对两组患者的人口统计学信息和血管造影数据进行回顾性分析。
两组的基线特征具有可比性。与使用3.5 JL导管相比，使用我们新制作的导管进行右侧经桡动脉颈动脉血管造影时，使用的造影剂较少（55 mL对66 mL，P<0.001），总透视时间较短（3.60±1.85分钟对3.14±1.55分钟，P<0.001）。新制作的导管还使选择性显影成功率更高（97%对40%，P<0.001）。两种导管的轻微并发症发生率相当（6.5%对6.6%，P=0.234）。两组均未观察到永久性损伤、发病或死亡。
现有的导管和方法不足以进行常规经桡动脉颈动脉血管造影。对于常规经桡动脉颈动脉血管造影，需要创新设计的导管。我们开发的用于经桡动脉颈动脉血管造影的导管在获得满意图像方面比传统导管更成功。使用新设计的导管可以获得高质量的图像。
使用我们新开发的颈动脉导管可以进行经桡动脉颈动脉血管造影。可以对患有广泛冠状动脉疾病的患者的颈动脉进行显影，同时可以治疗具有高卒中风险的无症状患者，预防潜在的卒中发生。在更大规模的比较研究中，可能会证明常规使用新方法的有益作用以及卒中发生率的降低。
