球囊辅助指引导管通过迂曲桡动脉完成经桡动脉冠状动脉介入治疗的可行性探讨

发布时间：2025-09-24 02:22

了解冠状动脉搭桥手术和冠状动脉介入治疗 #生活知识# #科技生活# #健康生活技巧# #冠心病#

目的评估经桡动脉行经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）,遇到桡动脉严重迂曲指引导管无法通过时,应用球囊辅助技术（balloon-assisted tracking,BAT）通过迂曲段,完成治疗的可行性。方法 2016年1月—2018年6月行经桡动脉冠状动脉介入治疗的病例,如果遇到桡动脉严重迂曲,有时可完成冠状动脉造影,但如果需要介入治疗,指引导管却无法通过,遇到该情况随机分为2组,各16例,BAT组：更换或加入经皮冠状动脉腔内成形术（percutaneous transluminal coronary angioplasty,PTCA）导丝通过迂曲段,联合预扩张球囊辅助通过迂曲桡动脉。改左侧桡动脉组：重新穿刺左侧桡动脉入路行PCI。比较2组成功率、操作时间、放射线剂量（dose area product,DAP）、穿刺入路并发症等。结果 2组患者均成功完成PCI,BAT组操作指引导管到位时间短于改左侧桡动脉组,透视时间长于改左侧桡动脉组,放射线剂量要高于改左侧桡动脉组,穿刺血管并发症2组差异无统计学意义。结论指引导管可以在轻柔谨慎的操作下应用BAT技术通过迂曲桡动脉完成冠心病介入治疗,而避免更换入路,增加患者负担及痛苦。

Abstract

Objective To evaluate the feasibility of balloon-assisted tracking（BAT）being used to aid guide catheters through the tortuous radial artery during percutaneous coronary intervention（PCI）via the transradial approach. Methods Between January 2016 and June 2018,a total of 32 patients with tortuous radial arteries who were scheduled to undergo transradial PCI were recruited.Radial arteriography was performed when the radial artery was too tortuous. When guide catheters failed to get through the radial artery, the patients were randomized into two groups with sixteen cases in each. In the BAT group（group A）, PTCA guidewire and balloons with a diameter of 2.0 mm were used to get through the tortuous radial artery.In group B, the left radial artery approach was adopted. The success rate of surgery, duration of operation, dose area product（DAP）, vascular complications were recorded and compared between the two groups. Results PCI was successfully completed in both groups. The time of catheter placement in BAT group was shorter than that in the left radial artery group, the fluoroscopy time and radiation dose was longer than that in the left radial artery group. There was no significant difference in the complications of puncture vessels between the two groups. The difference in the vascular complication rate was insignificant. Conclusion BAT technique can help increase the success rate of PCI by aiding guide catheters through tortuous radial arteries during TRA.

关键词

桡动迂曲 /球囊辅助技术 /经皮冠状动脉介入治疗{{custom_keyword}} /

Key words

tortuous radial artery /balloon-assisted tracking /percutaneous coronary intervention{{custom_keyword}} /

引用本文

导出引用

王磊, 傅涛, 罗建平, 李利军, 李慧君, 马宏宇, 白旭鹏.球囊辅助指引导管通过迂曲桡动脉完成经桡动脉冠状动脉介入治疗的可行性探讨. 空军航空医学. 2020, 36(2): 123-125 https://doi.org/10.3969/j.issn.2095-3402.2020.02.011

WANG Lei, FU Tao, LUO Jianping, LI Lijun, LI Huijun, MA Hongyu, BAI Xupeng.Feasibility of balloon-assisted tracking of guide catheters through tortuous radial artery during transradial coronary intervention. Aviation Medicine of Air Force. 2020, 36(2): 123-125 https://doi.org/10.3969/j.issn.2095-3402.2020.02.011

参考文献

[1] Louvard Y,Lefevre T.Loops and transradial approach in coronary diagnosis and intervention[J].Catheter Cardiovasc Interv,2000,51(2):250-252.
[2] Lo TS,Nolan J,Fountzopoulos E,et al.Radial artery anomaly and its influence on transradial coronary procedural outcome[J].Heart,2009,95(5):410-415.
[3] Yohei Numasawa,Akio Kawamura,Shun Kohsaka,et al.Anatomical variations affect radial artery spasm and procedural achievement of transradial cardiac catheterization[J].Heart Vessels,2014:29(1):49-57.
[4] Rathore S,Morris JL.The radial approach:is this the route to take[J].J Interv Cardiol,2008,21(5):375-379.
[5] Valsecchi O,Vassileva A,Musumeci G,et al.Failure of transradial approach during coronary interventions:anatomic considerations[J].Catheter Cardiovasc Interv,2006,67(6):870-878.
[6] Patel T,Shah S,Pancholy S.Balloon assisted tracking of a guide catheter through difficult radial anatomy:A technical report[J].Catheter Cardiovasc Interv,2013,81(5):E215-E218.
[7] 倪祝华,王乐丰,杨新春,等.经桡动脉路径介入治疗时应用经皮冠状动脉介入治疗导丝和球囊辅助指引导管成功跨越痉挛段33例分析[J].中国介入心脏病学杂志,2016,24(6):320-325.