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JL指引导管用于右冠状动脉慢性闭塞硬病变介入治疗(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第5期
页码:
544-546
栏目:
临床研究
出版日期:
2006-10-25

文章信息/Info

Title:
JL guiding percutaneous intervention of right coronary chronic total occlusion
作者:
吕安林; 苑媛; 陈丹; 刁繁荣; 李军杰; 胡小菁
第四军医大学西京医院心血管内科， 陕西 西安 710032
Author(s):
Lv An-lin;  YUANYuan;  CHENDan;  DIAO Fan-long;  LI Jun-jie;  HU Xiao-jing
Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi′an, Shaanxi 710032, China
关键词:
冠状动脉疾病; 介入; 指引导管
Keywords:
coronary disease;  intervention;  guiding catheter
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 探讨右冠状动脉慢性闭塞硬病变的介入治疗（PCI）方法，对比分析经桡动脉和股动脉途径采用JR、JL和AL指引导管介入治疗右冠状动脉慢性闭塞硬病变的适应证和并发症。方法 2003年1月至 2005年7月右冠状动脉慢性闭塞行PCI者 305例，分别采用桡动脉JR，AL/JL导管法和股动脉JR/AL导管法PCI。观察指引导管置入成功率，钢丝通过率，球囊扩张成功率和支架置入成功率及各种并发症的发生率。结果 上述3种方法的指引导管放置成功率均很高，但钢丝通过率、球囊扩张和支架置入成功率，桡动脉JL/AL导管法（99%, 98%, 98%）显著高于桡动脉JR（75%, 63%, 63%）和股动脉JR/AL导管法（83%, 77%, 77% ，P<0.05）。无严重并发症发生。结论 右冠状动脉慢性闭塞硬病变介入治疗JL/AL指引导管法优于桡动脉和股动脉JR指引导管法，并发症发生率没有增加。
Abstract:
AIM To study the method of percutaneous coronary intervention (PCI) of right coronary chronic total occlusion and to analyze indications and complications of PCI with JR, JL or AL guiding by radial or femoral approach. METHODS From January of 2003 to July of 2005, PCI was conducted with JR or JL/AL guiding by radial or JR/AL by femoral approach in.305 cases with right coronary chronic total occlusion. The successful rate of guided placement, wire crossing, balloon expanding and stent placement as well as the incidence of various complications were observed in these patients. RESULTS The successful rate of guided catheter placement of these three methods was very high. The successful rate of wire crossing, balloon expanding and stent placement with JL/AL catheter by radial (99%, 98%, 98% respectively) was higher (P<0.05) than that with JR catheter by radial (74%, 63%, 63% respectively) and that by femoral artery (82%, 77%, 77%, respectively). There were no severe complications. CONCLUSION The percutaneous coronary intervention of right coronary chronic total occlusion with JL/AL catheter by radial is superior to that with JR catheter by radial femoral artery.

参考文献/References

［1］ Kilian JG, Celermajer DS, Adams MR. Safety of coronary angioplasty to chronic total occlusions［J］. Int J Cardiol, 2005, 103(3): 256-258.

［2］ Ochiai M, Ashida K, Araki H, et al. The latest wire technique for chronic total occlusion［J］. Ital Heart J, 2005, 6(6): 489-493.

［3］ 韩雅玲, 张剑, 荆全民,等. 慢性完全闭塞冠状动脉病变1148例患者的介入治疗［J］. 中华心血管病杂志，2005, 33(4): 7-10.

［4］ Drozd J, Opalinska E, Zapolski T, et al. Percutaneous transluminal coronary angioplasty for chronic total coronary occlusion in patients with stable angina. Relationship between lesion anatomy, procedure technique and efficacy［J］. Kardiol Pol, 2005, 62(4): 332-342.

［5］ Christofferson RD, Lehmann KG, Martin GV,et al. Effect of chronic coronary occlusion on treatment strategy［J］. Am J Cardiol, 2005, 95(9): 1088-1091.

备注/Memo

备注/Memo:
收稿日期：2006-01-05.通讯作者：吕安林，副主任医师，主要从事冠心病介入治疗研究 Tel：（029）84771040 Email：lvanlin@fmmu.edu.cn
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