SAL指引导管使用56例初步经验

Experiences of using guiding catheter SAL for percutaneous coronary intervention in 56 patients

目的:初步总结短头AL(short amplatz left,SAL)指引导管(guiding catheter,GC)的使用经验,评价SAL GC的使用特点及安全性。方法:回顾分析总结我科56例使用SAL导管行右冠状动脉(RCA)介入治疗患者的影像特点,操作过程及最终结果。56例患者中慢性完全性闭塞(CTO)病变29例;病变迂曲8例;病变明显钙化10例;迂曲并发钙化5例;病变位于RCA远端且近中段迂曲14例。结果:56例患者中SAL GC成功到位53例(95%),3例不能到位。53例使用SAL GC完成PCI手术,PCI成功46例,成功率87%,失败7例(13%),均为CTO病变;CTO病变的成功率为76%(22/29),失败原因为导丝不能通过5例,术中过敏反应1例,心室颤动1例,均顺利中止手术。56例中无1例发生RCA开口或近端夹层,也无右窦内夹层发生。结论:SAL GC操作简单,容易到位,适合大部分RCA复杂病变,具有良好的安全性。

AIM： To summarize our experience with the use of guiding catheter （GC） SAL （Medtronics） for percutaneous coronary intervention （PCI） in 56 patients. METHODS ： Data were analyzed retrospec- tively in 56 patients who underwent coronary angiography （CAG） and PCI using SAL GC from July 2011 to January 2012. In all the patients, right coronary arteries （RCA） were the culprit arteries and the culprit lesions in RCA were complex lesions, including 29 chronic total occlusive lesions （CTO）, ten calcified lesions, eight tortuous lesions, and 14 distal lesions with tortuous RCA. RESULTS： SAL GC was used successfully in 53/56 patients and failed in placement of three patients. The success rate of PCI was 86. 8% （46/53） and PCI failed in seven patients with CTO. No dissection occurred in RCA or aortic sinus during the procedure. CONCLUSION： SAL GC can be used successfully in most complex lesions in RCA with good safety.