短头Amplatz left指引导管在经桡动脉右冠状动脉复杂病变治疗中的安全性及可行性  

Safety and feasibility of short Amplatz left guiding catheter for complex right coronary artery lesions in percutaneous coronary intervention via radial approach

作　　者：樊延明[1] 傅向华[2] 魏庆民[1] 史永堂[1] 张友良[1] 王晓刚[1] 林书坡[1] 

机构地区：[1]河北省邢台市人民医院心脏内科,054000 [2]河北医科大学第二医院,050000

出　　处：《国际心血管病杂志》2016年第1期50-53,共4页International Journal of Cardiovascular Disease

摘　　要：目的:探讨短头Amplatz left(SAL)指引导管在经桡动脉右冠状动脉(RCA)复杂病变经皮冠状动脉介入治疗(PCI)中的安全性和可行性。方法:入选2013年5月至2015年3月经择期冠状动脉造影证实为RCA复杂病变的冠心病患者120例,随机分为SAL组和Amplatz left(AL)组各60例。观察并比较两组PCI成功率、PCI手术时间、指引导管到位成功率、指引导管到位平均耗时、X线透视时间、造影剂用量等。记录并比较两组患者PCI术中并发症的发生率,随访术后30d主要不良心血管事件(MACE)。结果:两组PCI成功率、指引导管到位率、指引导管到位平均耗时、PCI手术时间、造影剂用量等均无显著性差异(P>0.05)。SAL组应用5in 6子母导管比例(16.7%对3.3%,P=0.033)、球囊锚定技术比例(25.0%对8.3%,P=0.027)及导丝数量(3.1±0.6对2.9±0.3,P=0.021)均高于AL组。SAL组术中并发症的发生率明显低于AL组(10.0%对26.7%,P=0.034)。两组术后30d内MACE发生率无显著差异(P>0.05)。结论:SAL指引导管的支撑力不及AL指引导管,但SAL导管同样能够完成大多数RCA复杂病变的治疗,且能够降低PCI术中并发症的发生率。Objective： To explore the safety and feasibility of short Amplatz left（SAL） guiding catheter for complex right coronary artery （RCA） lesions in percutaneous coronary intervention （PCI） via radial artery approach. Methods： From May 2013 to March 2015, a total of 120 patients of coronary heart disease with complex RCA lesions confirmed by elective coronary angiography were enrolled in this study. Patients were divided into SAL group （n=60） and Amplatz left（AL） group （n=60） randomly. The success ratio of PCI and guiding catheter placed, the duration of guiding catheter placed and PCI procedure, the volume of contrast media and so on were recorded and compared between the two groups. The incidence of complications during PCI procedure and major adverse cardiovascular events （MACE） during a follow up period of 30 days were recorded and compared between the two groups. Results： There was no significant difference in baseline characteristics between the two groups（P〉0. 05）. There was no significant difference between two groups in the volume of contrast media, the success ratios of PCI and guiding catheter placed, the duration of guiding catheter placed and PCI procedure （P〉0. 05）. Compared to the AL group, the proportion of patients with 5 in 6 guiding catheter technique （16.7% vs.3. 3%, P=0. 033）, anchored balloon technique （25.0% vs. 8. 3G, P=0. 027） and the amount of guide wires （3. 1 ±0. 6 vs. 2. 9±0. 3, P=0. 021） were much higher in SAL group. The incidence of complications during PCI procedure in SAL group was much lower than that in AL group （10.0% vs. 26.7%, P=0. 034）. There was no significant difference in MACEmajor adverse cardiovascular events during the follow-up period （P〉0. 05）. Conclusion： The back-up support of SAL is inferior to that of AL to some extent. Compared with AL, SAL can be successfully used in most complex lesions in RCA with lower incidence of complications during PCI.

关 键 词：短头Amplatz left指引导管 桡动脉 右冠状动脉 复杂冠状动脉病变 

分 类 号：R541.4[医药卫生—心血管疾病]