Guidezilla^(TM)延长导管在经皮冠状动脉介入治疗中的应用观察

Clinical efficacy and safety of Guidezilla^(TM) guide extension catheter application during difficult coronary percutaneous coronary intervention procedure

目的评估复杂冠状动脉病变行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)过程中,球囊或支架难以通过时补救性应用Guidezilla^(TM)延长导管的有效性和安全性。方法选取2015年1月至2016年1月第四军医大学西京医院收治的10例复杂冠状动脉病变行PCI术患者,因术中球囊或支架难以通过,补救性应用Guidezilla^(TM)延长导管支撑下辅助球囊或支架到达病变处完成手术。观察PCI术成功率、并发症以及随访6个月的主要不良心脏事件(包括心源性死亡、急性心肌梗死、靶血管再次血运重建)的发生情况。结果 10例患者中,2例为Guidezilla^(TM)延长导管辅助球囊通过,8例为辅助支架通过。所有患者在Guidezilla^(TM)延长导管辅助下都成功完成PCI,成功率100%,术后靶血管TIMI血流均为Ⅲ级,残余狭窄<20%。1例术中发生心绞痛,对症治疗后好转。所有患者无血管夹层或破裂、急性支架内血栓、导丝所致的穿孔和心脏压塞等事件发生。所有患者随访6个月无不良心脏事件发生。结论利用Guidezilla^(TM)延长导管在增强支撑力作用下辅助球囊和支架到达冠状动脉病变部位,手术成功率高,并发症发生率低,近期疗效满意。

Objective To evaluate the clinical efficacy and safety of Guidezilla^TM guide extension catheter which provide extra guidance support for equipment delivery during difficult coronary percutaneous coronary intervention（PCI） procedure. Methods There were totally 10 patients with coronary hear diseases including 7 cases of ACS and 3 cases of stable angina pectoris included in this study. Guidezilla^TM guide extension catheters were used in 5 CTO cases and in 5 calcified and tortuous lesion cases. The PCI success rate, incidence of complications and 6-month-follow up data were observed. Results In 8 cases, the Guidezilla^TM guide extension catheters were used for the delivery of stents to the intended lesion segments and in another 2 cases, the extension catheters were used for balloons delivery. PCI success rate was 100%. One patient had angina during PCI operation. No dissection was recorded and no acute myocardial infarction occurred. During 6 months of follow-up, there was no major adverse cardiac event （MACE）. Conclusions The use of Guidezilla^TM guide extension catheter can shorten the procedural time and ensure overall procedural success with reduced complication rate for complicated coronary lesions.