经桡动脉介入治疗复杂冠脉病变中Heartrail子母导管的作用

Safety and efficacy of Heartrail catheter in the treatment of confusion coronary disease by transradial approach

目的:评价Heartrail子母导管系统(5Fin 6F导管系统)在经桡动脉介入治疗复杂冠状动脉(冠脉)病变中,需要强支撑力输送支架时的有效性与安全性。方法:回顾性分析4年来我院经桡动脉介入治疗中应用常规方法不能通过的复杂冠脉病变患者36例(RCA 25例,LCX 6例,LAD 5例),选择应用Heartrail子母导管系统深插入靶血管提供强支持力以输送支架,观察患者的临床特征,冠脉造影所见病变特点,操作成功率,并发症发生率,随访术后主要心脏不良事件的发生率。结果:33例成功完成支架植入,操作成功率为92%,3例失败(8%)。术中术后无严重并发症,无死亡病例。结论:经桡动脉行经皮冠脉介入治疗复杂冠脉病变过程中,子母导管系统应用于常规方法不能成功的冠脉复杂病变可深插增加支撑力,有助于远端支架植入,应用安全有效。

Objective：To assess the safety and efficacy of Heartrail catheter ＂five-in-six catheter system＂ as a distal stent delivery system to enhance back-up support during difficult coronary stent delivery in transradial coro- nary intervention. Method： We performed 36 cases using the Heartrail catheter to improve backup support and facilitate stent delivery following failure of conventional techniques. The intracoronary catheter was inserted into 25 right coronary arteries, 6 left circumflex arteries and 5 left anterior descending arteries. The Heartrail deeply intubated the target vessel. We recorded clinical characteristic, PCI operating result and the related situation dur- ing peri-procedure stage. Result： Stent delivery using the Heartrail catheter was successful in 33 cases （92 %） and unsuccessful in 3 cases （8%）. There were no serious complications related to deep incubation of the catheter, and no death case. Conclusion：Use of the Heartrail catheter is safe and highly effective in PCI procedures where stent deployment initially failed during the standard approach. This catheter system enhances back-up support and facili- tates deep intubation and stent delivery beyond the site of obstruction.