双腔微导管联合锚定球囊在经桡动脉6 F指引导管处理分叉病变中的应用分析

Application of Kaneka dual lumen microcatheter combined with anchored balloon in treating bifurcation lesions via radial artery 6 F catheter

目的探讨双腔微导管联合锚定球囊在经桡动脉6 F指引导管处理老年患者分叉病变中的应用效果。方法回顾性分析2020年1月至2023年1月在北京朝阳医院心脏中心就诊的年龄≥60岁接受经桡动脉6 F指引导管处理分叉患者168例,按是否采用双腔微导管联合锚定球囊技术分为锚定组81例和对照组87例。比较2组冠状动脉病变特点、手术情况及主要不良心血管事件(major adverse cardiovascular events,MACE)。采用多因素logistic回归分析危险因素。结果锚定组边支夹层发生率、手术时间、X线曝光剂量、对比剂用量明显低于对照组(P<0.05,P<0.01)。锚定组术后12个月MACE发生率与对照组比较,差异无统计学意义(4.9%vs 8.0%,P>0.05)。边支夹层、边支最终血流心肌梗死溶栓试验<3级是老年分叉病变患者术后12个月MACE发生的独立危险因素(P<0.05,P<0.01)。结论双腔微导管联合锚定球囊技术在经桡动脉6 F指引导管处理分叉病变可有效缩短老年患者手术时间,减少X线曝光剂量,对比剂用量及边支夹层发生率。

Objective To investigate the efficacy of utilizing Kaneka dual lumen microcatheter in combination with anchored balloon in treatment of bifurcation lesions in elderly patients with radial artery 6 F catheter.Methods A retrospective analysis was performed on 168 patients(≥60 years) receiving bifurcation treatment with a 6 F catheter via the radial artery at the Heart Center of our hospital from January 2020 to January 2023.According to application of dual lumen microcatheters and anchoring balloon technology or not,they were assigned into an anchoring group(81 cases old) and a control group(87 cases).A comparison was made between the two groups in terms of features of coronary artery disease,operation procedure,and MACE.Multivariate logistic regression analysis was employed.Results Lower incidence of dissection,shorter operation time,less X-ray exposure dose,and decreased contrast agent dosage were observed in the anchoring group when compared with the control group(P<0.05,P<0.01).There was no statistical difference in the MACE incidence between the two groups(4.9% vs 8.0%,P>0.05).The side branch dissection and final TIMI grade <3 of side branch flow were independent risk factors for postoperative MACE in elderly patients with bifurcation lesions after surgery(P<0.05,P<0.01).Conclusion Kaneka dual lumen microcatheter combined with anchored balloon technology via radial artery 6 F catheter has the advantages in effectively shorting operation time,minimizing X-ray exposure,reducing contrast agent usage,and diminishing the incidence of side branch dissection in treatment of bifurcation lesions in elderly patients undergoing surgical treatment.