Javid Rabeia, Otieno Stephen O, Wheatcroft Stephen B, Arockiam Sacchin, Tayebjee Muzahir H
Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK.
Leeds General Infirmary, Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds LS1 3EX, UK.
J Clin Med. 2025 Sep 15;14(18):6487. doi: 10.3390/jcm14186487.
Percutaneous coronary intervention (PCI) is a widely performed revascularisation procedure for coronary artery disease. Although effective, its reliance on fluoroscopy and iodinated contrast exposes patients and operators to risks of radiation and nephrotoxicity. As PCI techniques have become more complex, interest has grown in imaging methods that reduce dependence on fluoroscopy and contrast. Electro-anatomical mapping systems (EAMS), developed for catheter navigation in electrophysiology, enable real-time three-dimensional visualisation without the need for fluoroscopy or contrast. By adapting coronary guidewires as electrodes, EAMS can reconstruct vessel anatomy and track interventional tools in real time. EAMS have demonstrated feasibility and safety in device implantation, and early studies suggest their applicability to PCI, where they may mitigate radiation and contrast exposure by providing an alternative method for guidewire and stent visualisation. This review provides a narrative overview of current evidence, outlining the technical principles, applications in device implantation, and the emerging role of EAMS in coronary intervention.
经皮冠状动脉介入治疗（PCI）是一种广泛应用于冠心病的血管重建手术。尽管有效，但它依赖于荧光透视和碘化造影剂，这使患者和操作人员面临辐射和肾毒性风险。随着PCI技术变得更加复杂，人们对减少对荧光透视和造影剂依赖的成像方法的兴趣与日俱增。为电生理中的导管导航而开发的电解剖标测系统（EAMS），无需荧光透视或造影剂就能实现实时三维可视化。通过将冠状动脉导丝用作电极，EAMS可以实时重建血管解剖结构并跟踪介入工具。EAMS已在设备植入中证明了其可行性和安全性，早期研究表明它们适用于PCI，通过提供导丝和支架可视化的替代方法，它们可能减轻辐射和造影剂暴露。本综述对当前证据进行了叙述性概述，概述了技术原理、在设备植入中的应用以及EAMS在冠状动脉介入治疗中的新兴作用。
