经桡动脉普通导引导管7F无鞘技术治疗冠状动脉复杂病变  

Sheathless transradial intervention using standard 7 Fr guide catheters to treat coronary complex lesions

作　　者：温尚煜[1] 王柏影[1] 刘亮[1] 黎辉[1] 

机构地区：[1]大庆油田总医院心内科,黑龙江大庆163001

出　　处：《中国介入心脏病学杂志》2014年第7期445-447,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的评价经桡动脉普通导引导管7 F无鞘技术治疗冠状动脉复杂病变的安全性、可行性。方法纳入2013年11月至2014年4月,经桡/尺动脉置入6 F桡动脉鞘造影后,需要用7 F导引导管行介入治疗的患者31例。在桡动脉鞘内置入长260 cm,直径0.036 in(1 in=2.54 cm)非亲水涂层导丝至升主动脉;撤出桡动脉鞘,将6 F 110 cm猪尾管插入7 F 100 cm导引导管内,猪尾管头端突出于导引导管外;将猪尾管和导引导管呈一体,穿入长260 cm,直径0.036 in导引导丝,通过皮肤切口逐次进入桡动脉,导引导管到位后撤出猪尾管。结果 31例导引导管均成功通过桡动脉,到达靶冠状动脉开口,完成介入治疗后撤出导引导管。术后观察24 h,所有患者桡动脉穿刺处无出血,穿刺侧上肢未发生血肿、感觉障碍。术后1个月随访,未发生桡动脉闭塞。结论经桡动脉普通导引导管7 F无鞘技术是治疗冠状动脉复杂病变可选用的相对安全、有效的途径。Objective To investigate the feasibility and safety of using sheathless standard 7Fr guiding catheters for transradial percutaneous coronary intervention （PCI） in complex lesions.Methods We identified 31 consecutive patients who received transradial PCI between November 2013 and April 2014 using 7 Fr large-bore guides catheters with a sheathless technique.The 6 Fr sheath was removed over a 0.035 inch,260 cm standard J-tip diagnostic guidewire,which was advanced through the sheath to the aortic root and fixed into position.A 100 cm 7 Fr standard guiding catheter with an inner 110 cm 6 Fr pigtail catheter was advanced over the wire as a single assembly inserted through the skin into the radial artery over the diagnostic guidewire.The 7 Fr guiding catheter was further advanced over the wire to the aortic root and manoeuvred to the coronary ostium,The 6 Fr pigtail catheter was removed.Results All 31 patients successfully underwent PCI according to the sheathless transradial technique with a 7 Fr standard guiding catheter.During the perioperative period,no major complications associated with vessel puncture.During the one month follow-up period,no radial artery occlusion was detected.Conclusions Transradial PCI using the sheathless technique may be a feasible and safe technique to treat coronary complex lesions.

关 键 词：桡动脉 无鞘技术 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]