Federman J, Bell M R, Wondrow M A, Grill D E, Holmes D R
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
J Am Coll Cardiol. 1994 Feb;23(2):347-51. doi: 10.1016/0735-1097(94)90418-9.
The aim of this study was to compare the duration of radiation exposure associated with new percutaneous coronary interventional devices with that associated with conventional balloon angioplasty.
Radiation exposure levels have been documented to be higher with coronary balloon angioplasty than with routine diagnostic coronary angiography. However, the effect of new interventional devices on radiation exposure has not been studied.
Fluoroscopic and cineangiographic data from the Mayo Clinic cardiac catheterization laboratory data base of patients having single-segment coronary intervention during a recent 46-month period were retrospectively analyzed. Of 897 patients studied, 646 underwent balloon angioplasty, 138 directional coronary atherectomy (42 with adjunctive balloon angioplasty), 76 excimer laser angioplasty (50 with adjunctive balloon angioplasty) and 37 placement of an intracoronary stent (16 emergencies).
Duration of fluoroscopy during balloon angioplasty was 24 +/- 18 min, which was longer than with directional atherectomy (18 +/- 8 min; p = 0.001). Fluoroscopy time was 25 +/- 17 min with laser angioplasty and 29 +/- 15 min with elective stent placement (neither time was significantly different from that with balloon angioplasty). When atherectomy or laser angioplasty was performed with adjunctive balloon angioplasty or if emergency intracoronary stent placement was performed, the duration of fluoroscopy was significantly prolonged compared with balloon angioplasty alone.
Fluoroscopy duration is not prolonged with the use of new interventional coronary devices compared with conventional angioplasty unless adjunctive balloon angioplasty is used or emergency stent placement is required.
本研究旨在比较新型经皮冠状动脉介入器械与传统球囊血管成形术相关的辐射暴露持续时间。
有文献记载，冠状动脉球囊血管成形术的辐射暴露水平高于常规诊断性冠状动脉造影。然而，新型介入器械对辐射暴露的影响尚未得到研究。
回顾性分析梅奥诊所心脏导管实验室数据库中近46个月内接受单节段冠状动脉介入治疗患者的荧光透视和电影血管造影数据。在研究的897例患者中，646例行球囊血管成形术，138例行定向冠状动脉斑块旋切术（42例联合球囊血管成形术），76例行准分子激光血管成形术（50例联合球囊血管成形术），37例行冠状动脉内支架置入术（16例为急诊）。
球囊血管成形术期间的荧光透视持续时间为24±18分钟，长于定向斑块旋切术（18±8分钟；p = 0.001）。激光血管成形术的荧光透视时间为25±17分钟，择期支架置入术为29±15分钟（两者时间与球囊血管成形术相比均无显著差异）。当斑块旋切术或激光血管成形术联合球囊血管成形术进行时，或进行急诊冠状动脉内支架置入术时，与单纯球囊血管成形术相比，荧光透视持续时间显著延长。
与传统血管成形术相比，使用新型冠状动脉介入器械不会延长荧光透视持续时间，除非联合使用球囊血管成形术或需要急诊支架置入。
