The use of a guide catheter extension system as an aid during transradial percutaneous coronary intervention of coronary artery bypass grafts
The use of a guide catheter extension system as an aid during transradial percutaneous coronary intervention of coronary artery bypass grafts
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DOI：
10.1002/ccd.22942
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发表时间：
2011-11-15
影响因子：
2.3
通讯作者：
Fraser, Douglas G.
中科院分区：
文献类型：
--
作者：
Farooq, Vasim;Mamas, Mamas A.;Fraser, Douglas G.
目的：术前冠状动脉旁路移植术（CABG）是经桡动脉PCI手术失败的主要预测因素之一。这通常是由于移植物插管困难和/或后援支持不良所致。除了Proxis （TM）的栓塞保护作用外，Proxi（TM）、Heartrail（TM）和guide （TM）导管延伸装置都被证明可以通过增加后备支持和辅助支架输送来促进冠状动脉介入治疗。我们描述了我们机构使用这些设备来辅助经桡骨移植物干预的经验。方法：2007年10月至2010年3月，在连续的经桡骨移植物介入手术中评估这些装置的实用性和安全性。排除仅用于近端保护的Proxis（TM）病例。深度插管定义为插管深度=2cm。结果：41例经桡骨移植干预中有33例使用了导管延伸。3例仅使用Proxi（TM）进行近端保护，其余30例作为研究组(Heartrail(TM) n = 18, GuideLiner（TM) n = 3, Proxis(TM) n = 9）。在所有的研究案例中，最终的TIMI-3流程都取得了手术上的成功。引导导管延伸用于移植物插管期间的辅助（n = 11），通过深度插管改善后备支持（n = 26），并作为辅助抽吸装置（n = 11）。11/21例hearttrai （TM）和GuideLiner（TM）病例采用基于过滤器的远端栓塞保护装置。深插管深度30 ~ 138 mm（平均61 mm），未见深插管相关并发症。结论：引导导管延伸系统的使用通过几种机制促进了经桡骨移植物介入，包括辅助移植物插管，增加后援支持，以及作为辅助抽吸装置。(c) 2011 Wiley期刊公司
Aims: Prior coronary artery bypass graft (CABG) surgery is one of the main predictors of failure of transradial PCI. Frequently this is due to difficulty in graft cannulation and/or poor backup support. In addition to Proxis's(TM) embolic protection role, the Proxi(TM), Heartrail(TM), and GuideLine(TM) guide catheter extension devices have all been shown to facilitate coronary intervention by increasing backup support and aiding stent delivery. We describe our institution's experiences using these devices to aid transradial graft intervention. Methods: Between October 2007 and March 2010, the utility and safety of these devices were assessed in consecutive transradial graft intervention procedures. Proxis(TM) cases used for proximal protection alone were excluded. Deep intubation was defined as an intubation depth of =2cm. Results: Guide catheter extensions were used in 33 of 41 transradial graft interventions identified. Proxi(TM) was used for proximal protection alone in 3 cases, leaving 30 cases as the study group (Heartrail(TM) n = 18, GuideLiner(TM) n = 3, Proxis(TM) n = 9). In all study cases procedural success with final TIMI-3 flow was achieved. Guide catheter extensions were used to aid during graft cannulation (n = 11), to improve backup support via deep intubation (n = 26) and as an adjunctive aspiration device (n = 11). Filter-based distal embolic protection devices were used in 11/21 Heartrai(TM) and GuideLiner(TM) cases. Deep intubation depths ranged from 30 to 138 mm (mean 61 mm) with no complications related to deep intubation seen. Conclusions: The use of guide catheter extension systems facilitated transradial graft intervention via several mechanisms including aid to graft cannulation, increasing backup support, and as an adjunctive aspiration device. (c) 2011 Wiley Periodicals, Inc.