Runthrough导丝辅助下无碘对比剂房间隔穿刺技术  

Runthrough guidewire-assisted atrial septal puncture with no use of iodine contrast agent:preliminary clinical results

作　　者：王劲风 方平 刘继纯 蔚有权 汪祥海 杨浩 WANG Jinfeng;FANG Ping;LIU Jichun;WEI Youquan;WANG Xianghai;YANG Hao(Department of Cardiology,First Afiliated Hospital of Wannan Medical College,Wuhu,Anhui Province 241001,China)

机构地区：[1]皖南医学院第一附属医院心内科,安徽芜湖241001

出　　处：《介入放射学杂志》2023年第5期427-430,共4页Journal of Interventional Radiology

基　　金：2021-2023年度心脏电生理科研培训基金项目。

摘　　要：目的 探索采用Runthrough导丝辅助下,结合X线透视技术完成无碘对比剂房间隔穿刺的方法。方法 2021年2月至10月在皖南医学院第一附属医院接受导管射频消融治疗的阵发性房颤患者60例,随机分为常规房间隔穿刺组30例和Runthrough导丝辅助房间隔穿刺组30例。比较两组患者在房间隔穿刺过程中的总操作时间、透视时间、X线放射剂量,评估安全性。结果 两组患者房间隔穿刺过程中的总操作时间[(1.98±0.29) min比(2.11±0.14) min]、透视时间[(1.83±0.30) min比(1.98±0.14) min]、X线放射剂量[(27.77±3.08)μGy·m2比(29.13±1.54)μGy·m2]差异均有统计学意义(均P<0.05)。所有患者均无心包填塞、主动脉穿孔等并发症发生。结论 X线透视下Runthrough导丝辅助的房间隔穿刺技术安全、经济、易行、可重复性强,可作为碘对比剂过敏患者房间隔穿刺的一种新方法。Objective To evaluate the clinical effectiveness and safety of fluoroscopy-guided Runthrough guidewire-assisted transseptal atrial puncture(TSAP)with no use of iodine contrast agent.Methods A total of 60 patients with paroxysmal atrial fibrillation,who received catheter radiofrequency ablation at the First Affiliated Hospital of Wannan Medical College of China between February and October of 2021,were enrolled in this study.The patients were randomly divided into conventional TSAP group(n=30)and Runthrough guidewireassisted TSAP group(n=30).The total operating time,fluoroscopy time,and X-ray radiation dose of accomplishing TSAP were compared between the two groups,and the technical safety was evaluated.Results The total operating time,fluoroscopy time and X-ray radiation dose in the conventional TSAP group were(1.98+0.29)min,(1.83+0.30)min and(27.77±3.08)μGy m^(2)respectively,which in the Runthrough guidewire assisted TSAP group were(2.11±0.14)min,(1.98+0.14)min and(29.13±1.54)μGy m^(2)respectively,the differences between the two groups were statistically significant(all P<0.05).In all patients no complications,such as pericardial tamponade,aortic perforation,etc.,occurred.Conclusion The technique of fluoroscopy-guided Runthrough guidewireassisted TSAP with no use of iodine contrast agent is clinically safe,economic,easy to operate,and repeatable.This technique can be used as an alternative method of conventional TSAP for patients with allergies to iodinated contrast agents.

关 键 词：房间隔穿刺 Runthrough导丝 碘对比剂 

分 类 号：R654.2[医药卫生—外科学]