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[经皮腔内冠状动脉成形术中两种低渗碘造影剂抗血栓形成潜力的电子显微镜比较]

[Electron microscopic comparison of the antithrombotic potential of 2 low osmolality iodine contrast media in percutaneous transluminal coronary angioplasty].

作者信息

Lefèvre T, Bernard A, Bertrand M, Lablanche J M, Cequier A, Espuglas E, Gayet J L, Gosselin G, Bonan R

机构信息

UCVI, clinique Henry-Hartmann, Neuilly-sur-Seine.

出版信息

Arch Mal Coeur Vaiss. 1994 Feb;87(2):225-33.

PMID:7802530
Abstract

The antithrombogenic potentials of two low osmolality iodine contrast media, ioxaglate (Iox), an ionic product, and iopamidol (Iop), a non-ionic product, were compared in a multicentre, randomised, double-blind study in 64 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) by scanning electron microscopy for the presence of thrombotic material on the guiding catheter (GC) and guide wires (GW). The procedure was strictly standardised: stable angina, type A coronary lesions; aspirin administration (at least 300 mg the day before and on the day of angioplasty); heparinisation (10000 IU at the beginning of the procedure); same GCs (Marathon Baxter 8F), same GWs (Veriflex USCI 0.014). The tips of the catheters and guide wires were scanned by an electronic microscope in a double-blind protocol. The scores for the number of erythrocytes (RBCs), platelets (PLs) and constituted thrombi (THi) were; thickness scored from 0 to 3, the % surface covered and an index of volume combining these two parameters. The clinical and angiographic characteristics of the 2 groups were strictly comparable. The time that the GCs and GWs were in the circulation were 30.0 +/- 2.3 vs 32.6 +/- 3.0 minutes for the former, and 18.6 +/- 1.8 vs 17.1 +/- 1.4 minutes for the later in the Iox and Iop groups, respectively (NS). An angiographic filling defect was not observed in any of the patients in the Iox group and in 4 patients (13%) in the Iop group (NS). The number of thrombotic elements observed on the GCs (RBCs, PLs, THi) was negligible in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在一项多中心、随机、双盲研究中,对64例行经皮腔内冠状动脉成形术(PTCA)的患者,通过扫描电子显微镜观察两种低渗碘造影剂——离子型产品碘克沙醇(Iox)和非离子型产品碘帕醇(Iop)在引导导管(GC)和导丝(GW)上血栓形成物质的情况,比较它们的抗血栓形成潜力。该操作严格标准化:稳定型心绞痛、A型冠状动脉病变;服用阿司匹林(血管成形术前一天及当天至少300毫克);肝素化(操作开始时10000国际单位);使用相同的GC(马拉松百特8F)和相同的GW(Veriflex USCI 0.014)。导管和导丝尖端采用双盲方案进行电子显微镜扫描。红细胞(RBC)、血小板(PL)和已形成血栓(THi)数量的评分;厚度从0到3评分,覆盖表面的百分比以及结合这两个参数的体积指数。两组的临床和血管造影特征严格可比。Iox组和Iop组中,GC和GW在循环中的时间分别为30.0±2.3分钟对32.6±3.0分钟,以及18.6±1.8分钟对17.1±1.4分钟(无显著性差异)。Iox组患者均未观察到血管造影充盈缺损,Iop组有4例患者(13%)出现(无显著性差异)。两组在GC上观察到的血栓形成元素数量(RBC、PL、THi)均可忽略不计。(摘要截选至250字)

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