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目的:在右冠状动脉(冠脉)起源异常的患者中,分析Ikari left指引导管寻找异常右冠开口的优势。方法:回顾2010-07-2014-07厦门大学附属第一医院心内科收治的60例非ST段抬高急性冠脉综合征合并右冠起源异常的患者,均在Ikari left指引导管的指引下成功寻找到右冠开口,其中30例为经皮冠脉介入(PCI)术治疗右冠病变,另外30例为右冠冠脉造影术。结果:4年内共计820例非ST段抬高急性冠脉综合征中有80例合并右冠起源异常,发生率9.76%,其中30例在Ikari left指引导管的指引下完成起源异常的右冠狭窄病变PCI术,发生率为3.66%;另外30例患者右冠为非犯罪血管,2例起源于左冠窦,1例起源于主动脉前壁,均在该指引导管下成功找到右冠开口。其余20例患者均为单支冠脉,右冠为回旋支中段或远段发出的分支,均在左冠造影的同时诊断。观察以上患者12个月,均无再发心绞痛,无心肌梗死、心力衰竭、心源性猝死、再次入院行冠脉血管化治疗等主要心血管事件出现。结论:Ikari left指引导管的独特设计结构在寻找起源异常的右冠开口时有着明显的优势,同时能安全有效地运用在这些右冠病变的PCI术中。
PURPOSE: To analyze the advantages of Ikari left guiding catheters in finding abnormal right coronary openings in patients with abnormalities of right coronary arteries (coronary arteries). Methods: A retrospective analysis was performed on 60 patients with non-ST-segment elevation acute coronary syndromes with abnormalities of the right coronary artery in the First Affiliated Hospital of Xiamen University from July 2010 to July 2014, all under the guidance of Ikari left guide catheter To find the right crown opening, of which 30 cases of percutaneous coronary intervention (PCI) for the treatment of right coronary artery disease, the other 30 cases of right coronary artery angiography. Results: Eighty-two of 820 non-ST-elevation acute coronary syndromes in 4 years were associated with abnormalities of the right coronary artery at a rate of 9.76%. Thirty of them underwent right-coronar stenosis with Ikari left guide catheter The incidence of PCI was 3.66%. In the other 30 patients, the right coronary artery was a non-criminal vessel, two of them originated from the left coronary artery, and one of them originated from the anterior wall of the aorta. All of them under the guidance catheter successfully found the right coronary ostium. The remaining 20 patients were single coronary artery, the right crown as the branch in the middle or distal circumflex, both in the left coronary angiography at the same time diagnosis. No significant recurrence of angina pectoris, no myocardial infarction, heart failure, sudden cardiac death, re-admission of coronary revascularization and other major cardiovascular events were observed in these patients over 12 months. Conclusions: The unique design of the Ikari left guide catheter has significant advantages in finding a right anterior coronaries with anomalous origin, and can safely and effectively be used in PCI of these right coronary lesions.