Grassman E D, Leya F S, Lewis B E, Johnson S A, McNulty J A, Sumida C W, McKiernan T L, Killian D M, Halle A A, Ward K A
Cardiology Section, Loyola University Medical Center, Maywood, IL 60153.
Cathet Cardiovasc Diagn. 1993;Suppl 1:48-53.
Side branch protection of bifurcation lesions with guide wires treated with directional coronary atherectomy has been performed safely in a small number of patients using a nickel/titanium (Nitinol) alloy guide wire. There is no information about the safety of using other guide wires in this scenario. The purpose of this study was to microscopically examine a variety of guide wires exposed to the directional coronary atherectomy (DCA) device in vitro. Eight common guide wires used in percutaneous coronary angioplasty were positioned in a side branch of a simulated coronary bifurcation and exposed to the operating DCA device. The guide wires were examined grossly and under scanning electron microscopy. The Nitinol guidewire suffered no discernible damage in comparison to varying degrees of damage seen on the other guide wires, and this guidewire appears to be best suited for side branch protection. Examination of the protecting guide wire and cutting cylinder used in the initial patients also showed no damage. Further clinical trials are necessary to assess the efficacy of DCA under such conditions.
使用镍钛（Nitinol）合金导丝对接受定向冠状动脉斑块旋切术治疗的分叉病变进行边支保护，已在少数患者中安全实施。目前尚无关于在此种情况下使用其他导丝安全性的信息。本研究的目的是在体外显微镜下检查暴露于定向冠状动脉斑块旋切术（DCA）装置的各种导丝。将经皮冠状动脉成形术中使用的8种常见导丝置于模拟冠状动脉分叉的边支中，并暴露于正在操作的DCA装置。对导丝进行肉眼检查和扫描电子显微镜检查。与其他导丝出现的不同程度损伤相比，镍钛诺导丝没有明显损伤，并且这种导丝似乎最适合边支保护。对最初患者使用的保护导丝和切割导管进行检查也未发现损伤。需要进一步的临床试验来评估在此种情况下DCA的疗效。
