Guidezilla延长管辅助旋磨在复杂冠状动脉钙化病变介入治疗中的应用

Application of Guidezilla extension catheter assisted rotational atherectomy in interventional treatment of complex coronary artery calcification lesions

目的评价Guidezilla延长管辅助旋磨在复杂冠状动脉钙化病变介入治疗中的有效性和安全性。方法连续入选2018年1月至2021年12月首都医科大学附属北京安贞医院冠状动脉造影检查提示冠状动脉重度钙化病变患者45例,术中使用Guidezilla延长管辅助旋磨治疗。分析患者的临床基本资料、病变特点、旋磨治疗情况、术中并发症及住院期间主要不良心血管事件发生情况。结果45例患者冠状动脉钙化血管分布以右冠状动脉为主(21例,46.7%),其余包括左前降支11例(24.4%),左回旋支13例(28.9%)。冠状动脉钙化病变解剖学特征主要有以下特点:开口异常(9例,20.0%)、近段迂曲成角(8例,17.8%)、远段病变(28例,62.2%)。所有患者均旋磨成功并置入支架,钙化病变长度(18±6)mm、旋磨转速(17.1±1.2)×104 r/min、旋磨时间(1.4±0.4)min。术中未发生旋磨头嵌顿、血管破裂、严重夹层等并发症,住院期间无主要不良心血管事件发生。结论在复杂冠状动脉钙化病变中使用Guidezilla延长管辅助旋磨是安全、有效的手术方法。

Objective To evaluate the efficacy and safety of Guidezilla extension catheter assisted rotational atherectomy in the interventional treatment of complex coronary artery calcification lesions.Methods A total of 45 patients with severe coronary artery calcification detected by coronary angiography in Beijing Anzhen Hospital,Capital Medical University from January 2018 to December 2021 were consecutively enrolled.The Guidezilla extension catheter was used to assist rotational atherectomy.The basic clinical data,lesion characteristics,rotational atherectomy treatment,intraoperative complications and major adverse cardiovascular events during hospitalization were analyzed.Results The distribution of coronary artery calcification in 45 patients was mainly the right coronary artery(21 cases,46.7%),the rest included the left anterior descending artery(11 cases,24.4%)and left circumflex artery(13 cases,28.9%).The anatomical features of coronary artery calcification mainly included abnormal opening(9 cases,20.0%),tortuosity of the proximal segment(8 cases,17.8%),and distal lesion(28 cases,62.2%).Rotational atherectomy was successfully performed and stents were implanted in all patients.The length of calcified lesions was(18±6)mm,the rotational speed was(17.1±1.2)×104 r/min,and the rotational time was(1.4±0.4)min.There were no intraoperative complications such as burr incarceration,vascular rupture,severe dissection,and other complications.No major adverse cardiovascular events occurred during hospitalization.Conclusions The Guidezilla extension catheter assisted rotational atherectomy is a safe and effective procedure for the treatment of complex coronary artery calcification lesions.