磁导航系统在急性冠状动脉综合征介入治疗中的初步应用研究

Clinical study on the invasive treatment in patients with non-ST-elevation acute coronary syndromes guided by the magnetic navigation system

目的 :探讨磁导航系统在非ST抬高型急性冠脉综合征(non-ST-elevation acute coronary syndromes,NSTE-ACS)介入治疗中应用的可行性和安全性。方法:连续选择接受磁导航辅助介入治疗的中-高危NSTE-ACS患者37例,分别记录靶病变特征、导丝通过病变的时间、X线暴露时间、造影剂用量和相关并发症。用STATA9.2软件进行数据分析。结果:磁导航引导治疗靶病变37处,其中A/B1型病变7处、B2型病变17处、C型病变13处。术前靶病变平均狭窄程度和长度分别为(88.07±8.33)%和(27.08±8.98)mm。在磁导航指引下,磁导丝顺利通过36处靶病变,病变通过率为97.3%;失败1例,磁导丝未能通过1处次全闭塞伴严重钙化病变。磁导丝通过靶病变的平均时间为(82.0±67.9)s,其中A/B1、B2、C型病变的通过时间分别为(34.7±4.5)s、(61.0±14.7)s和(134.8±92.6)s;X线平均暴露时间(62.6±57.6)s,A/B1、B2、C型病变的暴露时间分别为(22.3±4.7)s、(45.2±14.5)s、(106.9±78.4)s;造影剂平均用量(6.3±4.6)ml,A/B1、B2、C型病变用量分别为(2.7±0.7)ml、(5.1±2.6)ml、(9.8±5.7)ml。介入术中未出现与应用导丝相关的冠状动脉夹层、穿孔等并发症;术后未发生心血管复合事件。结论:磁导航系统应用于NSTE-ACS的辅助介入治疗有可行性,磁导丝病变通过率高、安全性好。

Objective：To investigate the efficacy and safety of magnetic navigation system in patients with non-ST-elevation acute coronary syndromes（NSTE-ACS）.Methods： Total 37 consecutive patients with NSTE-ACS were assigned to undergo magnetic guide-wire navigation PCI（MPCI）.Time to cross lesion,fluoroscopy time,contrast usage to cross lesion and procedure-related complication were recorded and analyzed.Results： Of the 37 culprit lesions in MPCI,36 were crossed successfully giving a success rate of 97.3%.The average stenosis of the target lesions was（88.07 ± 8.33）%,mean length was（27.08 ± 8.98） mm.The procedure and the fluoroscopy time to cross the lesion in the magnetic PCI were（82.0 ± 67.9） s and（62.6 ± 57.6） s,respectively.The contrast medium used to cross lesion were（6.3 ± 4.6） ml.The failed lesion was a subtotal stenosis combined with severe calcification.No magnetic navigation system associated complications or major adverse cardiac events were observed in MPCI.Conclusion： It is feasible and safe to use the magnetic navigation system as a tool for treatment in patients with NSTE-ACS.