新型锥形导丝延长导管辅助完成复杂经皮冠状动脉介入治疗。
A novel tapered guide extension catheter facilitated successful completion of complex percutaneous coronary intervention.
机构信息
Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
National Clinical Research Center for Interventional Medicine, Shanghai, China.
出版信息
Eur J Med Res. 2023 Feb 25;28(1):101. doi: 10.1186/s40001-023-01067-w.
BACKGROUND
Guide extension catheters (GEC) are widely applied to cope with insufficient backup support in complex percutaneous coronary intervention (PCI). In the study, we aim to evaluate the feasibility and safety with a novel 5-4F tapered GEC used in complex lesion.
METHODS
The single-center retrospective study enrolled a total of 615 patients, in whom the 5F or 5-4F Expressman GEC was used to facilitate PCI procedure. Demographic and procedural data were collected.
RESULTS
5F GEC was used in 295 patients and 5-4F tapered GEC in 320 patients. The average age was 63.6 ± 11.0 years and 81.6% of the patients were male. Severe calcification and chronic total occlusion (CTO) were the commonest indication for the GEC use. The 5-4F tapered GEC was frequently used in active greeting technique (AGT) during CTO intervention procedure than 5F GEC (6.1% vs. 13.1%, p < 0.001). The average depth of intubation was 41.5 ± 19.6 mm for the 5-4F tapered GEC and 24.4 ± 15.1 mm for 5F GEC (p < 0.001). The rate of successful device delivery with 5-4F GEC was higher than 5F GEC (95.6% vs. 98.4%, p = 0.037). Pressure damping with 5F GEC occurred frequently than 5-4F GEC (7.4% vs. 2.5%, p < 0.05). Similarly, the incidence of intraoperative hypotension was higher in 5F GEC than 5-4F GEC (4.7% vs.1.9%, p < 0.05).
CONCLUSIONS
The novel 5-4F tapered GEC was superior to the 5F GEC in facilitating successful completion of PCI in the majority of patients with complex lesions via transradial approach.
背景
导引导管延长导管（GEC）广泛应用于复杂经皮冠状动脉介入治疗（PCI）中以应对不足的支撑力。在这项研究中，我们旨在评估新型 5-4F 渐缩 GEC 在复杂病变中的应用的可行性和安全性。
方法
这项单中心回顾性研究纳入了共 615 例患者，其中使用 5F 或 5-4F Expressman GEC 来辅助 PCI 手术。收集了患者的人口统计学和手术数据。
结果
295 例患者使用 5F GEC，320 例患者使用 5-4F 渐缩 GEC。患者平均年龄为 63.6±11.0 岁，81.6%为男性。严重钙化和慢性完全闭塞（CTO）是使用 GEC 的常见适应证。5-4F 渐缩 GEC 在 CTO 介入治疗中较 5F GEC 更常使用主动迎接技术（AGT）（6.1% vs. 13.1%，p<0.001）。5-4F 渐缩 GEC 的平均插管深度为 41.5±19.6mm，而 5F GEC 为 24.4±15.1mm（p<0.001）。5-4F GEC 成功输送器械的比例高于 5F GEC（95.6% vs. 98.4%，p=0.037）。5F GEC 中出现压力衰减的频率高于 5-4F GEC（7.4% vs. 2.5%，p<0.05）。同样，5F GEC 术中低血压的发生率高于 5-4F GEC（4.7% vs. 1.9%，p<0.05）。
结论
新型 5-4F 渐缩 GEC 在经桡动脉途径治疗大多数复杂病变患者的 PCI 中优于 5F GEC，有助于更顺利地完成手术。
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