Corsair微导管辅助Stingray球囊正向夹层再进入技术开通冠状动脉慢性完全闭塞病变的应用研究  

The study of Corsair microcatheter assisted Stingray balloon antegrade dissection re-entry technique in recanalization of coronary chronic total occlusion lesions

作　　者：陈根锐 高好考 王欢 沙治霖 申安心 谢魏炜 廉坤 陶凌 李成祥 CHEN Gen-rui;GAO Hao-kao;WANGHuan;SHA Zhi-lin;SHEN An-xin;XIE Wei-wei;LIAN Kun;TAO Ling;LI Cheng-xiang(Department of Cardiology,The First Affi liated Hospital of PLA Air Force Military Medical University,Xi’an 710032,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院心血管内科,陕西西安710032 [2]汉阴县人民医院心内科

出　　处：《中国介入心脏病学杂志》2022年第2期129-134,共6页Chinese Journal of Interventional Cardiology

基　　金：国家自然科学基金青年科学基金项目(81500272);国家自然科学基金面上项目(81670229);陕西省科学技术研究发展计划项目(2016SF-034);陕西省重点研发计划一般项目-社会发展领域(2018SF-153)。

摘　　要：目的探讨改良性BridgePoint系统即Corsair微导管替代CrossBoss导管辅助Stingray球囊的正向夹层再进入技术开通冠状动脉慢性完全闭塞(CTO)病变的安全性及有效性。方法对2016年6月至2019年9月空军军医大学第一附属医院连续应用Corsair微导管替代CrossBoss导管辅助Stingray球囊的正向夹层再进入技术尝试开通45例CTO病变患者的安全性、有效性进行分析。结果45例患者中男性41例(91.1%),平均年龄(58.5±12.6)岁,日本多中心CTO注册研究评分(J-CTO)为(2.42±0.75)分,均为补救性正向夹层再进入技术开通病变,均采用改良性BridgePoint系统即Corsair微导管替代CrossBoss导管辅助Stingray球囊的正向夹层再进入技术。40例(88.9%)开通成功,其中Corsair到位后调整导丝进入真腔3例,5例失败后通过其他正向技术或(和)逆向技术补救成功4例,导丝通过总体成功率为44例(97.8%)。2例围术期心肌梗死,均为非ST段抬高型心肌梗死;1例因边支闭塞行急诊介入再次血运重建,住院期间主要不良心血管事件(MACE)发生率为6.7%,手术成功42例(93.3%)。平均手术时间为(158±62)min,对比剂用量(452±167)ml。结论改良性BridgePoint系统即Corsair微导管替代CrossBoss导管辅助Stingray球囊的正向夹层再进入技术开通CTO病变成功率较高,安全可行。Objective To investigate the effectiveness and safety of BridgePoint system,which is Corsair microcatheter assisted Stingray balloon antegrade dissection re-entry technique(ADR),compared with CrossBoss in recanalization of coronary chronic total occlusion(CTO)lesions.Methods A total of 45 consecutive patients who underwent CTO PCI using the Corsair microcatheter based Stingray ADR from June 2016 to September 2019 were enrolled.Results There were 41(91.1%)of patients were men.The mean age was(58.5±12.6)years.The average J-CTO score was(2.42±0.75).The overall recanalization success rate was 88.9%(40/45 cases)and guidewire success rate was 97.8%(44/45 cases).Two patients had periprocedural myocardial infarction,both were nonST segment elevation myocardial infarction,and one occurred emergent revascularization due to urgent branch occlusion.The in-hospital major adverse cardiovascular events(MACE)rate was 6.7%.The mean procedure time was(158±62)min and the average amount of contrast dose was(452±167)ml.Conclusions Use of the Corsair microcatheter based Stingray ADR for CTO PCI is associated with high success rate and safety.

关 键 词：慢性完全闭塞病变 经皮冠状动脉介入治疗 正向夹层再进入技术 

分 类 号：R541.4[医药卫生—心血管疾病]