Ikarileft指引导管在右冠状动脉起源异常患者中的运用  

The application of Ikari left catheter guiding in the search of anomalous origin of right coronary artery

作　　者：梁玲[1] 李卫华[1] 谢强[1,2] 唐蓉[1] 姜毅[1] 林开敏[1] 韩俊愈[1] 

机构地区：[1]厦门大学附属第一医院心内科,厦门361000 [2]福建医科大学第一临床医学院心内科

出　　处：《临床心血管病杂志》2017年第7期639-642,共4页Journal of Clinical Cardiology

摘　　要：目的:在右冠状动脉(冠脉)起源异常的患者中,分析Ikari left指引导管寻找异常右冠开口的优势。方法:回顾2010-07-2014-07厦门大学附属第一医院心内科收治的60例非ST段抬高急性冠脉综合征合并右冠起源异常的患者,均在Ikari left指引导管的指引下成功寻找到右冠开口,其中30例为经皮冠脉介入(PCI)术治疗右冠病变,另外30例为右冠冠脉造影术。结果:4年内共计820例非ST段抬高急性冠脉综合征中有80例合并右冠起源异常,发生率9.76%,其中30例在Ikari left指引导管的指引下完成起源异常的右冠狭窄病变PCI术,发生率为3.66%;另外30例患者右冠为非犯罪血管,2例起源于左冠窦,1例起源于主动脉前壁,均在该指引导管下成功找到右冠开口。其余20例患者均为单支冠脉,右冠为回旋支中段或远段发出的分支,均在左冠造影的同时诊断。观察以上患者12个月,均无再发心绞痛,无心肌梗死、心力衰竭、心源性猝死、再次入院行冠脉血管化治疗等主要心血管事件出现。结论:Ikari left指引导管的独特设计结构在寻找起源异常的右冠开口时有着明显的优势,同时能安全有效地运用在这些右冠病变的PCI术中。Objective：To make advantages of the Ikari left catheter guiding in the search of anomalous origin of right coronary artery.Method：Among 820 patients who were diagnosed non-ST segment elevation acute myocardial infarction in 4consecutive years（2010.7-2014.7）,coronary angiography in 60 patients with anomaly of right coronary origin was performed successfully under the guide of Ikari left guiding.In half of them,percutanous coronary intervention was achieved with the same guiding.Result：The total number of anomaly of right coronary artery in those 820 patients was 80（9.76%）,in which 30（3.66%）had underwent PCI of the stenosis of right coronary artery with anomalous origin from the left sinus of Valsava under the support of Ikari left guiding.Other 30 patients,2from the left sinus of Valsava and 10 from the anterior of the ascending aorta,with anomalous origin of right coronary artery without severe stenosis underwent CAG in the support of Ikari left guiding.The left 20 patients with a single coronary artery which branches the right coronary artery from the middle segment or the distal segment of the left circumflex arteries were diagnosed under the left coronary artery angiographying.No serious complication like angina,heart failure,myocardial infarction,cardiac sudden death and revascularization,developed in those patients after a 12-monthes follow-up.Conclusion：Ikari left guiding has obvious and positive potential to search the anomalous origin of the right coronary artery and can provide the strong backup to make PCI performed effectively and safely.

关 键 词：Ikari left指引导管 右冠状动脉起源异常 冠状动脉内支架植入术 

分 类 号：R541.4[医药卫生—心血管疾病]