Cardiology, Hull University Teaching Hospitals NHS Trust, Hull, UK
Cardiology, Ain Shams University Faculty of Medicine, Cairo, Egypt.
BMJ Case Rep. 2023 Aug 16;16(8):e254029. doi: 10.1136/bcr-2022-254029.
After a successful percutaneous coronary intervention to the left anterior descending artery, the guide catheter was pulled without a wire inside and so was kinked in the radial artery. It was not possible to pull or push the kinked catheter due to severe pain and fear of radial artery injury/perforation due to 'razor effect' of the two sharp edges of the kinked segment. Retrograde balloon-assisted tracking technique was used through femoral access, 7 F guide catheter, percutaneous transluminal coronary angioplasty wire and inflated 2.5×15 mm balloon partially outside the catheter tip to facilitate moving the kinked catheter to the aorta where unravelling was possible using a snare and a 0.035' wire. This technique helped to keep control of both catheters, and avoid the 'razor effect' and radial artery injury. It could be suggested as the initial solution to sort similar problems due to its safety and efficacy.
经皮冠状动脉介入治疗左前降支后，导引导管内无导丝，在桡动脉内成角。由于严重疼痛以及担心因成角段的两个尖锐边缘的“剃刀效应”而导致桡动脉损伤/穿孔，无法拉动或推送成角的导管。通过股动脉入路，使用逆行球囊辅助跟踪技术，7 F 导引导管、经皮腔内冠状动脉成形术导丝和充气 2.5×15 mm 球囊部分超出导管尖端，以方便将成角导管移动到主动脉，在那里可以使用圈套器和 0.035"的导丝解开导管。该技术有助于控制两个导管，避免“剃刀效应”和桡动脉损伤。由于其安全性和有效性，它可以作为解决类似问题的初始方法。
