Tsai Sou-Chan, Chen Michael Yu-Chih, Chuo Sing-Kai, Wang Ji-Hung
Department of Cardiology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Tzu Chi Med J. 2021 Aug 23;34(1):102-106. doi: 10.4103/tcmj.tcmj_27_21. eCollection 2022 Jan-Mar.
The Kimny guiding catheter is a single universal guiding catheter used for performing percutaneous coronary intervention (PCI) in both the right coronary artery (RCA) and the left coronary artery (LCA). Although this guiding catheter has been shown to yield high procedural success rates in nonemergent conditions, its feasibility for patients with ST-segment elevation myocardial infarction (STEMI) remains unknown and therefore needs to be further investigated.
We retrospectively enrolled 62 consecutive STEMI patients who underwent primary PCI using the Kimny guiding catheter from January 2016 through December 2017. We then evaluated the rates of engagement and procedural success for PCI of the LCA and RCA with the Kimny guiding catheter.
Primary PCI of the infarct-related artery (IRA) by means of the Kimny guiding catheter proved to be successful in 61 of the STEMI patients (98.3%). Besides, the procedural success rate was found to be 100% (44/44) for the LCA and 94.4% (17/18) for the RCA ( = 0.293). With regard to contralateral (non-IRA) angiography, engagement rates of 97.4% (38/39) and 100% (18/18) were obtained for the RCA and LCA, respectively, ( = 1.0). No coronary artery ostial dissection was observed during the procedures. The mean number of total catheters used for each patient turned out to be only 1.035.
Using the Kimny guiding catheter for primary PCI is feasible and results in high procedural success rates, particularly for the treatment of the LCA, with fewer catheters, and at a lower cost.
金尼引导导管是一种单一通用的引导导管，用于在右冠状动脉（RCA）和左冠状动脉（LCA）中进行经皮冠状动脉介入治疗（PCI）。尽管已证明这种引导导管在非紧急情况下能产生较高的手术成功率，但其在ST段抬高型心肌梗死（STEMI）患者中的可行性仍未知，因此需要进一步研究。
我们回顾性纳入了2016年1月至2017年12月期间连续62例使用金尼引导导管进行直接PCI的STEMI患者。然后，我们评估了使用金尼引导导管对LCA和RCA进行PCI的到位率和手术成功率。
在61例STEMI患者（98.3%）中，通过金尼引导导管对梗死相关动脉（IRA）进行的直接PCI被证明是成功的。此外，发现LCA的手术成功率为100%（44/44），RCA的手术成功率为94.4%（17/18）（P = 0.293）。关于对侧（非IRA）血管造影，RCA和LCA的到位率分别为97.4%（38/39）和100%（18/18）（P = 1.0）。手术过程中未观察到冠状动脉开口处夹层。结果显示，每位患者使用的导管总数平均仅为1.035根。
使用金尼引导导管进行直接PCI是可行的，并且能产生较高的手术成功率，特别是在治疗LCA时，使用的导管数量更少，成本更低。
