球囊辅助指引导管通过迂曲桡动脉完成经桡动脉冠状动脉介入治疗的可行性探讨被引量：9

Feasibility of balloon-assisted tracking of guide catheters through tortuous radial artery during transradial coronary intervention

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摘要目的评估经桡动脉行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI),遇到桡动脉严重迂曲指引导管无法通过时,应用球囊辅助技术(balloon-assisted tracking,BAT)通过迂曲段,完成治疗的可行性。方法2016年1月-2018年6月行经桡动脉冠状动脉介入治疗的病例,如果遇到桡动脉严重迂曲,有时可完成冠状动脉造影,但如果需要介入治疗,指引导管却无法通过,遇到该情况随机分为2组,各16例,BAT组:更换或加入经皮冠状动脉腔内成形术(percutaneous transluminal coronary angioplasty,PTCA)导丝通过迂曲段,联合预扩张球囊辅助通过迂曲桡动脉。改左侧桡动脉组:重新穿刺左侧桡动脉入路行PCI。比较2组成功率、操作时间、放射线剂量(dose area product,DAP)、穿刺入路并发症等。结果 2组患者均成功完成PCI,BAT组操作指引导管到位时间短于改左侧桡动脉组,透视时间长于改左侧桡动脉组,放射线剂量要高于改左侧桡动脉组,穿刺血管并发症2组差异无统计学意义。结论指引导管可以在轻柔谨慎的操作下应用BAT技术通过迂曲桡动脉完成冠心病介入治疗,而避免更换入路,增加患者负担及痛苦。 Objective To evaluate the feasibility of balloon-assisted tracking(BAT)being used to aid guide catheters th rough the tor t uous radial ar ter y du r ing percutaneous coronar y inter vention(PCI)via the t ransradial approach. Methods Between January 2016 and June 2018,a total of 32 patients with tortuous radial arteries who were scheduled to undergo transradial PCI were recruited.Radial arteriography was performed when the radial artery was too tortuous. When guide catheters failed to get through the radial artery, the patients were randomized into two groups with sixteen cases in each. In the BAT group(group A), PTCA guidewire and balloons with a diameter of 2.0 mm were used to get through the tortuous radial artery.In group B, the left radial artery approach was adopted. The success rate of surgery, duration of operation, dose area product(DAP), vascular complications were recorded and compared between the two groups. Results PCI was successfully completed in both groups. The time of catheter placement in BAT group was shorter than that in the left radial artery group, the fluoroscopy time and radiation dose was longer than that in the left radial artery group. There was no significant difference in the complications of puncture vessels between the two groups. The difference in the vascular complication rate was insignificant. Conclusion BAT technique can help increase the success rate of PCI by aiding guide catheters through tortuous radial arteries during TRA.

作者王磊傅涛罗建平李利军李慧君马宏宇白旭鹏 WANG Lei;FU Tao;LUO Jianping;LILijun;LI Huyun;MA Hongyu;BAI Xupeng(Department of Cardiology,Jingmei Group General Hospital,Beijing 102300,China)

机构地区北京京煤集团总医院心内科空军特色医学中心心内科

出处《空军医学杂志》 2020年第2期123-125,共3页 Medical Journal of Air Force

关键词桡动迂曲球囊辅助技术经皮冠状动脉介入治疗 tortuous radial artery balloon-assisted tracking percutaneous coronary intervention

分类号 R61 [医药卫生—外科学]

作者简介通信作者:傅涛,E-mail:futao292@sina.com。

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