Guides
Guides
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指南
DOI：
10.1002/9781119383031.ch3
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Thach N. Nguyen
中科院分区：
文献类型：
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作者：
D. Vassilev;Pham Nhu Hung;Luan Ngo;Duy Chung;Thach N. Nguyen
最佳导向器为操作者提供了一个稳定的平台，以将器械推进到冠状动脉口，通过迂曲的动脉段，并穿过狭窄的病变。本章涉及导向器设计、导向器操作和导向器选择，以及LAD病变、LCX病变、RCA病变和冠状动脉异常的导向器。根据升主动脉的大小、插管口的位置以及靶区域近端冠状动脉段的迂曲和钙化程度选择导引器。在主动脉夹层的情况下，所选择的动脉进入路径可能不允许进入真实的主动脉腔。由于这些原因，应与外科医生仔细讨论血管造影术的目标。有经验的介入医生应了解冠状动脉异常的所有变化，并在有问题的血管不是来自其通常位置时系统地搜索其他主动脉窦。
An optimal guide provides a stable platform for the operator to advance devices to the coronary ostium, through tortuous arterial segments, and across tight lesions. This chapter deals with guide design, guide manipulations, and guide selection as well as guides for LAD lesions, LCX lesions, RCA lesions, and coronary anomalies. The guide is selected according to the size of the ascending aorta, the location of the ostia to be cannulated, and the degree of tortuosity and calcification of the coronary segment proximal to the target area. In a case of aortic dissection, the arterial entry route chosen may not allow access to the true aortic lumen. For these reasons, a careful discussion of the goals of angiography should be carried out with the surgeon. An experienced interventionist should be aware of all variations of coronary anomalies and systematically search in other aortic sinuses when the vessel in question does not arise from its usual location.