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用于冠状动脉手术的线圈栓塞:基础、适应症和技术。

Coils embolization use for coronary procedures: Basics, indications, and techniques.

作者信息

Loh Shu Xian, Brilakis Emmanuelle, Gasparini Gabriele, Agostoni Pierfrancesco, Garbo Roberto, Mashayekhi Kambis, Alaswad Khaldoon, Goktiken Omer, Avran Alexandre, Knaapen Paul, Nap Alex, Elguindi Ahmed, Tammam Khalid, Yamane Masahisa, Stone Gregg W, Egred Mohaned

机构信息

Cardiothoracic Department, Freeman Hospital, Newcastle upon Tyne, UK.

Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA.

出版信息

Catheter Cardiovasc Interv. 2023 Nov;102(5):900-911. doi: 10.1002/ccd.30821. Epub 2023 Sep 5.

Abstract

The use of coils is fundamental in interventional cardiology and can be lifesaving in selected settings. Coils are classified by their materials into bare metal, fiber coated, and hydrogel coated, or by the deliverability method into, pushable or detachable coils. Coils are delivered through microcatheters and the choice of coil size is important to ensure compatibility with the inner diameter of the delivery catheter, firstly to be able to deliver and secondly to prevent the coil from being stuck and damaged. Clinically, coils are used in either acute or in elective setting. The most important acute indication is typically the sealing coronary perforation. In the elective settings, coils can be used for the treatment of certain congenital cardiac abnormalities, aneurysms, fistulas or in the treatment of arterial side branch steal syndrome after CABG. Coils must always be delivered under fluoroscopy guidance. There are some associated complications with coils that can be acute or chronic, that nictitates regular followed-up. There is a need for education, training and regular workshops with hands-on to build the experience to use coils in situations that are infrequently encountered.

摘要

线圈的使用在介入心脏病学中至关重要,在特定情况下可能挽救生命。线圈按材料可分为裸金属、纤维涂层和水凝胶涂层,或按输送方式分为可推送或可分离线圈。线圈通过微导管输送,选择合适的线圈尺寸对于确保与输送导管的内径兼容很重要,一方面要能够输送,另一方面要防止线圈卡住和损坏。临床上,线圈可用于急性或择期情况。最重要的急性适应证通常是封堵冠状动脉穿孔。在择期情况下,线圈可用于治疗某些先天性心脏异常、动脉瘤、瘘管或冠状动脉旁路移植术后动脉侧支盗血综合征的治疗。线圈必须始终在透视引导下输送。使用线圈存在一些相关并发症,可能是急性或慢性的,这就需要定期随访。需要进行教育、培训并定期举办实践工作坊,以积累在不常遇到的情况下使用线圈的经验。

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