摘要
目的:探讨主动脉弓解剖分型对颈动脉支架置入术技术指标的影响。方法:回顾性分析2011-01至2012-12阜外心血管病医院连续224例单侧颈动脉支架置入术资料。记录颈动脉支架置入术中插入颈动脉的导管类别及型号、操作技术(1.回撤翻转直接插入;2.回撤翻转+导丝引导;3.回撤翻转+导丝引导+子导管支撑;4.特殊造影导管+导丝引导+子母导管)、操作X线曝光时间、对比剂用量及操作相关并发症。主动脉弓解剖按Myla分型分为Ⅰ、Ⅱ、Ⅲ三型。结果:224例患者Ⅰ型弓7例(3.1%),Ⅱ型弓113例(50.4%),Ⅲ型弓104例(46.4%)。104例Ⅲ型弓有48例(46.2%)患者使用特殊技术(技术3、4),比Ⅰ型弓1例(14.3%)、Ⅱ型弓17例(14.9%)明显增高(P<0.05);Ⅲ型主动脉弓患者较Ⅰ型弓、Ⅱ型弓患者在曝光时间、使用对比剂量及操作失败率方面均明显增多(P均<0.05);Ⅲ型弓患者手术成功率(96.2%)低于Ⅰ型弓(100%)、Ⅱ型弓(100%)患者(P<0.05)。操作相关并发症:Ⅲ型弓患者中并发症总计发生率(22.1%)高于Ⅰ型弓(0)、Ⅱ型弓(8.9%)患者(P<0.05)。结论:主动脉弓形态是影响颈动脉支架置入术技术指标的重要因素,Ⅲ型弓使颈动脉支架置入术的难度增加,并发症增多。
Objective： To explore the effect of the aortic arch type on technical indicators in patients with carotid artery stent implantation.Methods： We retrospectively analyzed 224 consecutive patients treated in Fu Wai hospital for unilateral carotid artery stent implantation from 2011-01 to 2012-12. We summarized the catheter category, type and the operating techniques including ① retracement, turn and insertion of the catheter, ② retracement, turn of catheter＋the guidance of guide wire,③ retracement, turn of catheter＋the guidance of guide wire＋the supporting of another catheter, ④ using special graphic catheter＋the guidance of guide wire＋the supporting of another catheter. The procedural X-ray exposure time, dosage of contrast agent and operation related complications were recorded. According to Myla classiifcation, the aortic arches were divided into Myla Ⅰ, Myla Ⅱ and Myla Ⅲ types. Results： There were 7/224 （3.1%） patients with Myla Ⅰ aortic arch, 113 （50.4%） with Myla Ⅱ aortic arch and 104 （46.4%） with Myla Ⅲ aortic arch. A total of 48/104 （46.2%） Myla Ⅲ patients used special techniques （tech③, tech④）, it was more than the patients with Myla Ⅰ, （1/7,14.3%） and Myla Ⅱ （17/113, 15.0%）, P〈0.01. The patients with Myla Ⅲ aortic arch had the longer X-ray exposure time and used the higher dose of contrast agent, all P〈0.01. The procedural success rate in patients with Myla Ⅲ was 96.2%, it was lower than those with Myla Ⅰ （100%） and Myla Ⅱ （100%）, P=0.045. The procedural complication rate in patients with Myla Ⅲ was 22.1%, it was higher than those with Myla Ⅰ （0%） and Myla Ⅱ （8.9%）, P=0.007. Conclusion： The aortic arch type is the important inlfuential factor for the techniques used in carotid stent implantation. There were more dififculties and complications for stent implantation in patients with Myla Ⅲ aortic arch.
出处
《中国循环杂志》
CSCD
北大核心
2015年第1期34-37,共4页
Chinese Circulation Journal
作者简介
沈松鹤 硕士研究生 主要研究方向：放射介入Email：shengsonghe337@163.com曾在阜外心血管病医院进修
通讯作者：蒋雄京Email：jxj103@hotmail.com
