Galli M, Zerboni S, Politi A, Cecconi P, Ferrari G
Divisione di Cardiologia, Radiologia, Ospedale S. Anna, Como.
G Ital Cardiol. 1998 Mar;28(3):267-73.
New possibilities for transcatheter treatment of the cardiovascular system are guaranteed with the improvement of materials and the availability of new devices. Nevertheless, a rationalization of the potential activity in this sector seems to be necessary, and it could arise through the presence of Catheterization Laboratories "open" to diagnostic procedures and therapy that are not confined to the coronary system. This clinical study reports the experiences and results of our work in this field.
During the period from May 1995 to May 1997, our laboratory performed 205 diagnostic procedures that did not involve the coronary system. Based on this diagnostic work, there emerged 91 cases with an indication for transcatheter intervention, which was subsequently performed at our laboratory. There were 68 peripheral angioplasty procedures on the iliofemoral axis, 2 angioplasties of the subclavian artery, 8 of the renal artery, 2 procedures involving the treatment of A-V fistulas, one case of femoral pseudoaneurysm treatment and 10 cases of transcutaneous pericardiotomy performed with a balloon catheter. All the procedures were performed by our laboratory staff using materials that are normally at our disposal.
Successful results were obtained in 65 out of the 68 peripheral angioplasty procedures and in all of the 8 renal and 2 subclavian angioplasties. The positioning of the endoprosthesis for the closure of the A/V fistula was effective in one of the two cases. The transcatheter treatment of the femoral pseudoaneurysm was successful. In all cases where a pericardiotomy was performed with a balloon catheter, there was no reoccurrence of cardiac tamponade during the follow-up period. No complications were noted as a result of any of the procedures.
Our experience documents how it is possible to increase the diagnostic and therapeutic options in a Catheterization Laboratory. However, willingness on the part of the staff to update their skills continually and collaborate with other specialists is necessary in order to maintain optimal operative standards.
随着材料的改进和新设备的出现，心血管系统的经导管治疗有了新的可能性。然而，该领域潜在活动的合理化似乎是必要的，这可能通过存在对不限于冠状动脉系统的诊断程序和治疗“开放”的导管实验室来实现。本临床研究报告了我们在该领域的工作经验和结果。
在1995年5月至1997年5月期间，我们的实验室进行了205例不涉及冠状动脉系统的诊断程序。基于这项诊断工作，出现了91例有经导管干预指征的病例，随后在我们的实验室进行了干预。其中有68例对髂股轴进行外周血管成形术，2例锁骨下动脉血管成形术，8例肾动脉血管成形术，2例涉及动静脉瘘治疗的程序，1例股动脉假性动脉瘤治疗病例以及10例使用球囊导管进行的经皮心包切开术。所有程序均由我们实验室的工作人员使用我们通常可用的材料进行。
68例外周血管成形术中有65例取得成功结果，8例肾动脉和2例锁骨下动脉血管成形术全部成功。用于闭合动静脉瘘的内置假体在两例中的一例中定位有效。股动脉假性动脉瘤的经导管治疗成功。在所有使用球囊导管进行心包切开术的病例中，随访期间均未出现心脏压塞复发。所有程序均未出现并发症。
我们的经验证明了在导管实验室增加诊断和治疗选择的可能性。然而，工作人员必须愿意不断更新技能并与其他专家合作，以维持最佳的手术标准。
