Guidezilla^(TM)延长导管在左前降支近端闭塞急性ST段抬高型心肌梗死直接经皮冠状动脉介入治疗术中的保护作用  

Protective effect of Guidezilla^(TM)extension catheter in the proximal segment of the left anterior descending artery on patients with acute ST-segment elevation myocardial infarction

作　　者：付金国[1] 高光仁 牛和平[1] 于恺 王磊 马占峰 郭润 李凤鹏 穆丽平 刘静[1] 张军[1] FU Jin-guo;GAO Guang-ren;NIU He-ping;YU Kai;WANG Lei;MA Zhan-feng;GUO Run;LI Feng-peng;MU Li-ping;LIU Jing;ZHANG Jun(Department of Cardiology,Cangzhou Central Hospital,Cangzhou 061001,China)

机构地区：[1]沧州市中心医院心内科,河北沧州061001

出　　处：《中国介入心脏病学杂志》2023年第10期747-753,共7页Chinese Journal of Interventional Cardiology

摘　　要：目的探讨主动应用Guidezilla^(TM)延长导管在急性前壁ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗(PCI)术中闭塞部位临近左前降支起始处的安全性。方法选择2019年3月至2023年7月收治的14例急性前壁ST段抬高型心肌梗死患者急诊冠状动脉造影发现闭塞部位距左前降支开口部10 mm以内的患者,介入术中均应用Guidezilla^(TM)延长导管主动深插至左前降支的闭塞部位保护左主干及左回旋支,观察所有患者手术成功情况、术中与住院期间并发症发生情况、随访3~6个月主要不良心脏事件发生情况。结果14例均应用Guidezilla^(TM)延长导管保护左主干及左回旋支后顺利完成球囊扩张或支架置入,手术成功率为100%。12例患者在Guidezilla^(TM)延长导管深插后进行了血栓抽吸,8例患者经Guidezilla^(TM)延长导管冠状动脉内注入替罗非班或注射用重组人尿激酶原。14例患者术中均无器械相关并发症发生,无血栓漂移至左主干、左回旋支等部位,无急性周围脏器栓塞等并发症发生。患者术中与住院期间未发生死亡或再发急性心肌梗死情况。14例患者中,12例患者完成6个月随访,2例患者完成3个月随访,所有患者均未发生心原性死亡、再发急性心肌梗死、靶血管再次血运重建等主要不良心脏事件。结论本研究表明对于急性前壁ST段抬高型心肌梗死患者急诊冠状动脉造影提示急性闭塞部位距左前降支开口部10 mm以内富含血栓的患者,急诊介入治疗中利用深插Guidezilla^(TM)延长导管可起到保护左主干、左回旋支,预防血栓移位的作用。Objective To evaluate the clinical safety and efficacy of Guidezilla^(TM)extension catheter in the proximal segment of the left anterior descending to prevent thrombus shifting to left circumflex or left main artery during primary percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction.Methods The 14 patients with acute occlusion in the proximal segment of the left anterior descending with acute ST-segment elevation myocardial were selected from March 2019 to July 2023,All patient were received emergency coronary interventional treatment.During the intervention,Guidezilla^(TM)extended catheter was used to protect the left main artery and left circumfl ex artery.The PCI success rate,incidence of complications and 3~6 months follow up data were observed.Results In 14 cases,Guidezilla^(TM)extended catheter was used to protect the left main artery and left circumfl ex artery,and all patient were successfully completed balloon expansion or stent implantation,PCI success rate was 100%.12 patients used Guidezilla^(TM)extended catheter deep insertion for thrombotic aspiration,and 8 patients were injected medicine into the coronary artery from the Guidezilla^(TM)extension catheter.In 14 patients,there were no instrument complications,no thrombosis drift to the left main artery and left circumfl ex artery,and no complications such as acute peripheral organ embolism.There was no death or acute myocardial infarction during the operation and hospitalization of the patient.During 3~6 months of follow-up,there was no major adverse cardiovascular event(MACE).Conclusions This study shows that for patients with acute ST-segment elevation myocardial infarction in the proximal segment of the left anterior descending.The use of deep insertion Guidezilla^(TM)extension catheter in emergency intervention can protect the left main artery and left circumfl ex artery.

关 键 词：急性心肌梗死 左前降支 经皮冠状动脉介入治疗 Guidezilla^(TM)延长导管 

分 类 号：R541[医药卫生—心血管疾病]