Gaia系列导丝在慢性完全性闭塞病变经皮冠状动脉介入治疗中的应用

Application of Gaia guidewires during percutaneous coronary intervention in patients with chronic total occlusion:a summarization on experience

目的总结Gaia系列导丝在慢性完全性闭塞(CTO)病变经皮冠状动脉介入治疗(PCI)中的应用经验。方法2017年1月至2018年5月期间对88例CTO患者使用了Gaia系列导丝进行了PCI手术,回顾性分析这些患者的临床及影像资料,并收集手术结果、术中并发症以及主要不良心血管(MACE)事件。结果在88例CTO患者中,50例患者的J-CTO评分≥3分,最终手术成功65例(成功率73.9%),使用Gaia系列导丝成功通过病变共50例(成功率56.8%)。Gaia失败组J-CTO评分≥3分、闭塞段长度>20 mm、使用股动脉入路以及行对侧造影指导的比例明显高于Gaia成功组。Gaia导丝导致冠状动脉穿孔1例,发生断裂1例,出现导丝严重毁损2例。结论Gaia系列导丝能够提高复杂CTO病变的成功率,但导丝毁损或断裂的风险应当给予重视。

Objective To sum up the experience on Gaia guidewires application during percutaneous coronary intervention(PCI)in patients with chronic total occlusion(CTO).Methods CTO patients(n=88)received PCI assisted by Gaia guidewires from Jan.2017 to May 2018.The clinical and image data were retrospectively analyzed,and operative outcomes,complications during PCI,and major adverse cardiovascular events(MACE)were collected from the patients.Results In 88 patients with CTO,there were 50 had J-CTO scores were≥3.PCI succeed in 65 cases(73.9%),and Gaia guidewires passed through the occlusion lesions successfully in 50 cases(56.8%,success group).In failure group,J-CTO scores were≥3,CTO length was>20 mm,and percentages of patients with femoral approach and contralateral angiography were significantly higher than those in success group.There was 1 case of coronary artery perforation due to Gaia guidewires,1 case with Gaia guidewires fracture,and there were 2 cases with Gaia guidewires bad damage.Conclusion Gaia guidewires can promote the success rate in complex CTO treatment,but Gaia guidewires fracture or damage should be paid attention to seriously.