“拘禁导丝”技术的临床应用:导丝及血管的选择  

Application of the “buddy-in-jail” technique during percutaneous coronary intervention:choice of wire and artery

作　　者：唐建军[1] 方臻飞[1] 胡信群[1] 唐亮[1] 赵延恕[1] 沈向前[1] 周胜华[1] TANG Jian-jun;FANG Zhen-fei;HU Xin-qun;TANG Liang;ZHAO Yan-shu;SHENG Xian-qian;ZHOU Sheng-hua(Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, China)

机构地区：[1]中南大学湘雅二医院心血管内科,湖南长沙410011

出　　处：《中国介入心脏病学杂志》2018年第5期279-282,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的评价"拘禁导丝"技术处理复杂病变的效果及安全性。方法纳入2014年6月至2017年6月在中南大学湘雅二医院、岳阳市人民医院、永州市人民医院、湘西自治州人民医院行经皮冠状动脉介入治疗的患者共12 640例,其中球囊或支架不能通过病变的患者25例,21例采用了"拘禁导丝"技术,根据"拘禁导丝"的选择分为亲水涂层导丝组(9例)和无亲水涂层导丝组(12例)。评价"拘禁导丝"技术的效果及安全性,比较选择不同"拘禁导丝"手术成功率及并发症发生情况。结果21例患者中18例(18/21)手术成功,其中同一支血管作为"拘禁导丝"置入血管成功9例(9/11),不同血管成功9例(9/10),两者比较差异无统计学意义(P=0.593)。亲水涂层导丝组手术成功7例(7/9),无亲水涂层导丝组成功11例(11/12),两组间比较差异无统计学意义(P=0.386)。所有患者"拘禁导丝"均成功拔除,无相关并发症发生。结论 "拘禁导丝"技术对于球囊或支架不能通过病变是可行的。Objective To evaluate the efficacy of the ‘ buddy-in-jail ＇ technique applied to complex coronary artery lesions during percutaneous coronary intervention.Methods A total of 12 640 PCI cases f rom 4 different hospitals admitted between June 2014 to June 2017 were reviewed. Among them, the balloons or stents were unable to be delivered into the lesions in 25 cases. The ＂buddy-in-jail＂ technique was applied in 21 of these 25 cases. According to the guidewires used, the 21 cases were divided into the hydrophilic coated guidewire group（n=9） and non-hydrophilic coated guidewire group（n=21）. The rates of procedural success and complications were compared between the 2 groups. Results 18 cases（18/21）were successf ully treated with the ＂buddy-in-jail ＂ technique. The success rates were similar between patients using the same artery（9/11） as the ＂buddy＂ vessel patients using other arteries（9/10）（P=0.593）. Procedural success rates were also similar between patients using hydrophilic-coated guidewires（7/9） and non-hydrophilic coated guidewires（11/12）（P=0.386）. All the wires were successfully taken out without complication.Conclusions ＂Buddy-in-jail＂ technique offers a potential alternative approach for patients with difficulty in delivering the balloon or stent to the target lesion.

关 键 词：“拘禁导丝”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]