Resar J R, Prewitt K C, Wolff M R, Brinker J A
Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287.
Cathet Cardiovasc Diagn. 1994 Jul;32(3):268-73. doi: 10.1002/ccd.1810320316.
Coronary angioplasty through smaller-diameter guiding catheters using predominantly fixed-wire balloon systems has been possible, but has had some limitations. The purpose of this prospective, nonrandomized study was to investigate the results of percutaneous transluminal coronary angioplasty using a new 6F guiding catheter with over-the-wire balloon systems. Coronary angioplasty using over-the-wire balloon systems through a new 6F guiding catheter was evaluated in 79 lesions in 70 patients and then compared to randomly selected procedures using 7F guiding catheters in 70 patients performed over the same time period. Coronary angioplasty through 6F guiding catheters and over-the-wire balloons including 8 long (30-mm) and 3 perfusion balloons was successful in 94.9% of lesions and in 94% of patients. Coronary angioplasty through 7F guiding catheters was successful in 97.5% of lesions and in 97.1% of patients, respectively. Success rates between 6F and 7F guiding catheter groups were similar overall and for proximal, mid, distal, or complex (total, subtotal, or length > 10-mm) lesions. There were no failures to withdraw the deflated balloon into the 6F guiding catheter. Vessel opacification after dilatation with the guidewire across the lesion was similar between the 6F and 7F guiding catheter groups. The mean change in hematocrit for the 6F procedures (-1.4 +/- 3.7%) was significantly lower than for the 7F procedures (-3.3 +/- 3.2%, P < 0.001). Coronary angioplasty using a variety of over-the-wire balloon catheters through a new 6F guiding catheter is feasible with success rates comparable to 7F guiding catheters. Angioplasty with this 6F guiding catheter reduces procedural blood loss compared to larger-lumen guiding catheters.
使用主要是固定导丝球囊系统通过较小直径的引导导管进行冠状动脉血管成形术是可行的，但存在一些局限性。这项前瞻性、非随机研究的目的是调查使用一种新型带导丝球囊系统的6F引导导管进行经皮腔内冠状动脉血管成形术的结果。对70例患者的79处病变使用新型6F引导导管通过导丝球囊系统进行冠状动脉血管成形术，并与同期对70例患者使用7F引导导管随机选择的手术进行比较。通过6F引导导管和包括8根长（30毫米）球囊和3根灌注球囊的导丝球囊进行的冠状动脉血管成形术在94.9%的病变和94%的患者中取得成功。通过7F引导导管进行的冠状动脉血管成形术分别在97.5%的病变和97.1%的患者中取得成功。6F和7F引导导管组之间的成功率总体上以及对于近端、中段、远端或复杂（完全、次全或长度>10毫米）病变相似。将瘪掉的球囊撤回6F引导导管没有失败情况。6F和7F引导导管组之间在导丝穿过病变进行扩张后的血管显影相似。6F手术的血细胞比容平均变化（-1.4±3.7%）显著低于7F手术（-3.3±3.2%，P<0.001）。通过新型6F引导导管使用各种导丝球囊导管进行冠状动脉血管成形术是可行的，成功率与7F引导导管相当。与大腔引导导管相比，使用这种6F引导导管进行血管成形术可减少手术中的失血。
