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四种不同诊断导管弯形用于经桡动脉冠状动脉造影单导管技术的安全性和有效性——前瞻性随机试点研究。TRACT 1:经桡动脉冠状动脉造影试验1

Safety and Efficacy of Four Different Diagnostic Catheter Curves Dedicated to One-Catheter Technique of Transradial Coronaro-Angiography-Prospective, Randomized Pilot Study. TRACT 1: Trans RAdial CoronaryAngiography Trial 1.

作者信息

Chyrchel Michał, Bartuś Stanisław, Dziewierz Artur, Legutko Jacek, Kleczyński Paweł, Januszek Rafał, Gallina Tomasz, Chyrchel Bernadeta, Surdacki Andrzej, Rzeszutko Łukasz

机构信息

Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego Street, 30-688 Cracow, Poland.

Second Department of Cardiology, Faculty of Medicine, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Cracow, Poland.

出版信息

J Clin Med. 2021 Oct 14;10(20):4722. doi: 10.3390/jcm10204722.

Abstract

Transradial coronaro-angiography (TRA) can be performed with one catheter. We investigate the efficacy of four different DxTerity catheter curves dedicated to the single-catheter technique and compare this method to the standard two-catheter approach. For this prospective, single-blinded, randomized pilot study, we enrolled 100 patients. In groups 1, 2, 3, and 4, the DxTerity catheters Trapease, Ultra, Transformer and Tracker Curve, respectively, were used. In group 5 (control), standard Judkins catheters were used. The study endpoints were the percentage of optimal stability, proper ostial artery engagement and a good quality angiogram, the duration of each procedure stage, the amount of contrast, and the radiation dose. The highest rate of optimal stability was observed in groups 2 (90%) and 5 (95%). Suboptimal results with at least one episode of catheter fallout from the ostium were most frequent in group 1 (45%). The necessity of using another catheter was observed most frequently in group 4. The analysis of time frames directly depending on the catheter type revealed that the shortest time for catheter introduction and for searching coronary ostia was achieved in group 2 (Ultra). There were no differences in contrast volume and radiation dose between groups. DxTerity catheters are suitable tools to perform TRA coronary angiography. The Ultra Curve catheter demonstrated an advantage over other catheters in terms of its ostial stability rate and procedural time.

摘要

经桡动脉冠状动脉造影(TRA)可通过一根导管完成。我们研究了四种不同的适用于单导管技术的DxTerity导管弯型的有效性,并将该方法与标准双导管方法进行比较。在这项前瞻性、单盲、随机试点研究中,我们招募了100名患者。在第1、2、3和4组中,分别使用了DxTerity导管的Trapease、Ultra、Transformer和Tracker Curve弯型。在第5组(对照组)中,使用标准的Judkins导管。研究终点包括最佳稳定性百分比、正确的冠状动脉口部对接情况和高质量血管造影的比例、每个操作阶段的持续时间、造影剂用量和辐射剂量。在第2组(90%)和第5组(95%)中观察到最佳稳定性的最高发生率。在第1组中,至少有一次导管从冠状动脉口部脱出的次优结果最为常见(45%)。在第4组中,最常观察到需要使用另一根导管的情况。对直接取决于导管类型的时间框架分析显示,在第2组(Ultra弯型)中,导管插入和寻找冠状动脉口部的时间最短。各组之间在造影剂用量和辐射剂量方面没有差异。DxTerity导管是进行TRA冠状动脉造影的合适工具。Ultra Curve导管在冠状动脉口部稳定性率和操作时间方面比其他导管具有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbaa/8541157/e99578b74931/jcm-10-04722-g001.jpg

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