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目的评价135 cm扩张微导管(corsair导管,Asahi Intec Co,Japan)在冠状动脉慢性完全闭塞(chronic total occlusion,CTO)病变经桡动脉正向经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)中的有效性及安全性。方法回顾性入选了本中心2010年6月至2014年2月81例经桡动脉途径应用135 cm扩张微导管进行正向导引钢丝技术治疗的CTO病变患者,分析正向CTO-PCI成功率、扩张微导管通过闭塞病变成功率、球囊导管通过闭塞病变情况及导引钢丝通过闭塞病变情况,并观察住院期间不良事件发生率。结果 81例应用135 cm扩张微导管经桡动脉正向介入治疗的患者中,66例患者正向导引钢丝通过CTO病变,65例患者正向CTO-PCI成功,成功率为80.2%;另有8例成功进行逆向导引钢丝介入治疗,总体PCI成功率90.1%。66例正向导引钢丝通过闭塞病变后,135 cm扩张微导管成功通过闭塞病变56例(84.8%);扩张微导管通过闭塞病变后,球囊导管的使用数量为1.3个,显著低于扩张微导管未通过闭塞病变患者。66例正向导引钢丝通过闭塞病变的患者中,应用Fielder XT导引钢丝34例(51.5%)。住院期间随访未见扩张微导管嵌顿、折断、头端受损、血管穿孔等不良事件发生,无严重不良心脏事件发生。结论应用扩张微导管经桡动脉途径行正向CTO-PCI治疗是安全、有效的,可以简化介入治疗操作步骤,减少球囊导管等器械的使用,提高CTO病变介入治疗的手术成功率。
Objective To evaluate the clinical value of 135 cm dilated microcatheter (corsair catheter, Asahi Intec Co., Japan) in percutaneous coronary intervention (PCI) of patients with chronic total occlusion of coronary artery (CTO) Effectiveness and safety. Methods Retrospectively selected 81 patients with CTO lesions who were treated with 135 cm dilatation microcatheter via radial artery during June 2010 to February 2014. The success rate of positive CTO-PCI, The success rate of microcatheter occlusion by dilation, the pathological changes of balloon catheter occlusion and the occlusion of guide wire were observed. The incidence of adverse events during hospitalization was also observed. Results Of the 81 patients who received 135 cm dilation microcatheter through radial artery interventional therapy, 66 patients had positive guide wire through CTO lesions and 65 patients were successful in CTO-PCI with a success rate of 80.2% 8 cases of successful reverse guided wire interventional treatment, the overall PCI success rate of 90.1%. Sixty-six cases (84.8%) of the 135 cases who had successfully passed the occlusion lesion through the dilated microcatheter after 66 cases of the positive guide wire passed the occlusion lesion. The number of balloon catheters used was 1.3 after the dilatation of the microcatheter through occlusion, which was significantly lower than that of the dilation Microcatheter did not pass the occlusion of the patient. Sixty-six patients with positive guide wire through occlusion were treated with Fielder XT guide wire in 34 cases (51.5%). During the hospital stay, there was no adverse events such as dilating microcatheter incarceration, rupture, head end injury and vascular perforation, and no serious adverse cardiac events occurred. Conclusions The application of dilated microcatheter via radial artery in the direction of CTO-PCI is safe and effective. It can simplify the procedure of interventional therapy, reduce the use of balloon catheters and other devices, and improve the success rate of CTO interventional surgery.