中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
10期
1059-1061
,共3页
胡永涛%高传玉%李芳%安家晨%李牧蔚%黄克钧%陈岩%牛振民%朱中玉%陈保利
鬍永濤%高傳玉%李芳%安傢晨%李牧蔚%黃剋鈞%陳巖%牛振民%硃中玉%陳保利
호영도%고전옥%리방%안가신%리목위%황극균%진암%우진민%주중옥%진보리
冠状动脉慢性闭塞%介入治疗%桡动脉
冠狀動脈慢性閉塞%介入治療%橈動脈
관상동맥만성폐새%개입치료%뇨동맥
Chronic coronary artery total occlusion%Intervention treatment%Radial artery
目的 探讨经桡动脉成功介入治疗单支冠状动脉慢性闭塞(CTO)病变的临床体会.方法 回顾分析经桡动脉成功介入治疗单支CTO病变103例患者的临床资料.结果 (1)103例患者中不稳定型心绞痛57例,稳定型心绞痛12例,陈旧性心肌梗死34例;病变闭塞时间≤6个月83例,病变闭塞时间＞6个月20例;(2)103例患者的介入路径血管均无严重迂曲及解剖结构变异,左前降支闭塞51例,左回旋支闭塞25例,右冠状动脉闭塞27例;慢性完全性闭塞24例,慢性功能性闭塞79例;边支无闭塞病变91例,无侧支形成87例,病变长度＜15 mm 67例,锥形病变81例;(3)最终完成介入术的Judkins、XB、EBU导引导管所占比例分别为37.86％、30.10％、29.13％;(4)成功通过病变的PILOT系列导引钢丝为64.08％;(5)首次通过病变并成功实施预扩张的1.25 mm直径系列球囊57例(55.34％),1.5 mm直径系列球囊38例(36.89％).结论 在术者经验丰富的基础上经桡动脉介入处理单支CTO病变可行,其成功介入与介入路径畅通无阻、靶血管具备特征性病变特点及合理选择器械密不可分.
目的 探討經橈動脈成功介入治療單支冠狀動脈慢性閉塞(CTO)病變的臨床體會.方法 迴顧分析經橈動脈成功介入治療單支CTO病變103例患者的臨床資料.結果 (1)103例患者中不穩定型心絞痛57例,穩定型心絞痛12例,陳舊性心肌梗死34例;病變閉塞時間≤6箇月83例,病變閉塞時間＞6箇月20例;(2)103例患者的介入路徑血管均無嚴重迂麯及解剖結構變異,左前降支閉塞51例,左迴鏇支閉塞25例,右冠狀動脈閉塞27例;慢性完全性閉塞24例,慢性功能性閉塞79例;邊支無閉塞病變91例,無側支形成87例,病變長度＜15 mm 67例,錐形病變81例;(3)最終完成介入術的Judkins、XB、EBU導引導管所佔比例分彆為37.86％、30.10％、29.13％;(4)成功通過病變的PILOT繫列導引鋼絲為64.08％;(5)首次通過病變併成功實施預擴張的1.25 mm直徑繫列毬囊57例(55.34％),1.5 mm直徑繫列毬囊38例(36.89％).結論 在術者經驗豐富的基礎上經橈動脈介入處理單支CTO病變可行,其成功介入與介入路徑暢通無阻、靶血管具備特徵性病變特點及閤理選擇器械密不可分.
목적 탐토경뇨동맥성공개입치료단지관상동맥만성폐새(CTO)병변적림상체회.방법 회고분석경뇨동맥성공개입치료단지CTO병변103례환자적림상자료.결과 (1)103례환자중불은정형심교통57례,은정형심교통12례,진구성심기경사34례;병변폐새시간≤6개월83례,병변폐새시간＞6개월20례;(2)103례환자적개입로경혈관균무엄중우곡급해부결구변이,좌전강지폐새51례,좌회선지폐새25례,우관상동맥폐새27례;만성완전성폐새24례,만성공능성폐새79례;변지무폐새병변91례,무측지형성87례,병변장도＜15 mm 67례,추형병변81례;(3)최종완성개입술적Judkins、XB、EBU도인도관소점비례분별위37.86％、30.10％、29.13％;(4)성공통과병변적PILOT계렬도인강사위64.08％;(5)수차통과병변병성공실시예확장적1.25 mm직경계렬구낭57례(55.34％),1.5 mm직경계렬구낭38례(36.89％).결론 재술자경험봉부적기출상경뇨동맥개입처리단지CTO병변가행,기성공개입여개입로경창통무조、파혈관구비특정성병변특점급합리선택기계밀불가분.
Objective To summarize the clinical experience of successful intervention in single chronic coronary actery total ocdusion (CTO) lesions by the transradial.Methods A retrospective analysis was conducted in 103 patients with single CTO lesions who got intervention treatment by the radial artery.Results ( 1 ) Of the 103 cases,57 cases had unstable angina,12 cases had stable angina,and 34 cases chronic myocardial infarction.Lesions' block time was ≤ 6 months in 83 cases,and ＞ 6 months in 20 cases.(2)The path vessels of the 103 patients have no severe tortuosity and anatomical structure variation.Fifty-one cases occurred left anterior descending occlusion,25 cases occurred left circumflex branches occlusion,and 27 cases occurred right coronary artery occlusion.Furthermore,24 cases had chronic complete occlusion,and 79 cases had chronic functional block.The side branches did not block in 91 cases,no lesions(bridge) collateral formation occurred in 87 cases,lesions length was less than 15 mm in 67 cases,and tapered lesions was observed in 81 cases.( 3 ) Final intervention rate via Judkins,XB,EBU guide catheter was 37.86％,30.10％ and 29.13％ respectively.(4)the PILOT successfully through the lesions for the series wire guided was 64.08％.(5) 1.25 mm diameter series with a balloon through the first lesions and successful expanding was observed in 57 cases (55.34％),and 1.5 mm diameter series with a balloon occurred in 38 cases(36.89％ ).Conclusion Intervention treatment by the radial of single CTO lesions is feasible for experienced performers.The successful intervention depends on path vessels unimpeded,target vessels with characteristic pathological features and reasonable choice of instruments.
