经桡动脉复杂冠状动脉介入治疗补救性5进6双导管技术临床观察研究

Observational Study of Bailout Use of 5-in-6 Double Catheter Technique in Treating Patients With Complex Coronary Lesions via Transradial Approach

目的:评估经桡动脉复杂冠状动脉(冠脉)介入治疗(PCI)时补救性应用5进6双导管技术的有效性及安全性。方法:选取连续经桡动脉复杂PCI时补救性应用5进6双导管技术的患者125例,其中多支血管病变114例(91.2%),靶血管中重度钙化、近端血管扭曲、慢性完全闭塞、病变长度>30 mm患者分别为64.0%、48.8%、36.0%及78.4%。结果:123例(98.4%)患者补救性应用5进6双导管技术后成功完成经桡动脉复杂PCI;2例(1.6%)患者改用股动脉入径后完成介入治疗。全部患者住院期内无死亡,5例(4.0%)发生围术期心肌梗死。在1年随访中,1例(0.8%)发生死亡,9例(7.2%)发生主要心脏不良事件。结论:补救性应用5进6双导管技术可提高经桡动脉复杂PCI的成功率,该技术应考虑作为PCI的常规后备选择。

Objective： To evaluate the efficacy and safety of bailout use of 5-in-6 double catheter technique in treating patients with complex coronary lesions via transradial percutaneous coronary intervention（PCI）. Methods ： A total of 125 consecutive patients who treated by using 5-in-6 double catheter technique in a bailout manner were studied, those patients were failure to initial stent implantation with conventional method. Multi-vessel disease was fond in 114 patients （91.2%）. The target vessel had moderate to severe calcification, proximal vessel tortuosity, chronic total occlusion, and the lesion 〉30mm were at 64. 0% ,48.8% ,36.0% and 78. 4% respectively. Results： 123 patients （98.4%）successfully went through bailout of 5-in-6 double catheter technique for stent delivery and implantation,2 patients （ 1.6% ） changed to femoral artery stent implantation. There were no in-hospital death, and 5 patients （4. 0% ）suffered from myocardial infarction at peri-operation period. During 1 year foUow-up, 1 patient （0. 8% ） died and 9 patients（7.2% ）had major adverse cardiac events. Conclusion：The bailout use of 5-to-6 double catheter technique may facilitate successful transradial PCI for treating the patients with complex coronary lesions, and it could be considered as a potential adjunctive approach for PCI application.