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经皮冠状动脉介入治疗中锚定球囊系统的加强:一项体外评估。

Reinforcement of the anchor balloon system in percutaneous coronary intervention: an in vitro assessment.

机构信息

Department of Cardiovascular Medicine, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, 520-0046, Japan.

出版信息

Cardiovasc Interv Ther. 2021 Apr;36(2):219-225. doi: 10.1007/s12928-020-00674-2. Epub 2020 May 19.

DOI:10.1007/s12928-020-00674-2
PMID:32430764
Abstract

We evaluated the factors that increase the maximum static friction force between the anchoring balloon and the vessel wall. The anchor technique in percutaneous coronary intervention (PCI) may be better supported by a guiding catheter. However, in some cases, the anchor balloon does not perform optimally due to slippage within the anchoring vessel. Furthermore, the optimal procedure for balloon anchoring remains unknown. We evaluated the maximum static friction force of the anchor balloon via in vitro assessments using a simulated vessel model and coronary balloons. The simulated vessel model was composed of polytetrafluoroethylene, and its inner diameter was 1.5 mm. The various-sized balloons (diameter: 1.5 mm, 1.75 mm, and 2.0 mm; length: 10 mm and 15 mm) were inflated within the simulated vessel at various atmospheres. The maximum static friction force was measured by pulling on the balloon catheter shaft using 10-g weights. We performed the same experiment with a jailing 0.014″ wire under the anchoring balloon. Evaluated wires included a silicon coating coil wire, hydrophilic coating coil wire, polymer-coated non-tapering wire, and polymer-coated tapered wire. The maximum static friction force between the anchoring balloon and the simulated vessel increased with an increase in inflation pressure and balloon length. However, increasing the balloon diameter was not effective. The jailing 0.014″ wire, particularly coil wire, was effective in increasing the maximum static friction force of the anchor balloon. A longer balloon, higher inflation pressure, and jailing coil wire could reinforce the anchor balloon system.

摘要

我们评估了增加锚固球囊与血管壁之间最大静摩擦力的因素。经皮冠状动脉介入治疗(PCI)中的锚定技术可能会更好地得到引导导管的支持。然而,在某些情况下,由于锚固血管内的滑移,锚定球囊的性能并不理想。此外,球囊锚固的最佳操作方法仍不清楚。我们通过使用模拟血管模型和冠状动脉球囊进行的体外评估来评估锚定球囊的最大静摩擦力。模拟血管模型由聚四氟乙烯组成,其内径为 1.5 毫米。各种尺寸的球囊(直径:1.5 毫米、1.75 毫米和 2.0 毫米;长度:10 毫米和 15 毫米)在模拟血管内以不同的气压膨胀。通过使用 10 克的重物拉动球囊导管轴来测量最大静摩擦力。我们在锚固球囊下用 0.014 英寸的结扎丝进行了相同的实验。评估的丝线包括硅涂层线圈丝、亲水涂层线圈丝、聚合物涂层非锥形丝和聚合物涂层锥形丝。锚固球囊与模拟血管之间的最大静摩擦力随充气压力和球囊长度的增加而增加。然而,增加球囊直径并没有效果。结扎 0.014 英寸的丝线,特别是线圈丝,有效地增加了锚固球囊的最大静摩擦力。更长的球囊、更高的充气压力和结扎的线圈丝可以增强锚定球囊系统。

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本文引用的文献

1
Successful fenestration using a chronic total occlusion-dedicated guidewire in a patient with catheter-induced dissection of the right coronary artery.一名右冠状动脉导管诱导性夹层患者使用慢性完全闭塞专用导丝成功开窗。
J Invasive Cardiol. 2011 Feb;23(2):84-6.