Takayasu arteritis(TA)is a rare systemic vasculitis of the aorta and its primary branches,which usually occurs in young women.Due to its insidious onset and lack of specific symptoms,this disease can be easily misdiag...Takayasu arteritis(TA)is a rare systemic vasculitis of the aorta and its primary branches,which usually occurs in young women.Due to its insidious onset and lack of specific symptoms,this disease can be easily misdiagnosed or missed.Approximately 50%of the patients having TA with pulmonary artery involvement develop pulmonary hypertension(PH).The 3-year survival rate among patients with TA-related PH is lower than that among patients with TA alone.Early balloon pulmonary angioplasty(BPA)can improve the clinical symptoms and survival of patients with stable TA.To the best of our knowledge,this is the first case reported in the English literature in which a“Guidezilla”catheter was used during BPA to treat stenosis and occlusion of the pulmonary artery caused by Takayasu arteritis(TA).展开更多
目的探讨Guidezilla^(TM)延长导管在冠状动脉慢性完全闭塞病变(chronic total occlusion,CTO)行逆向经皮冠状动脉介入治疗时协助导丝通过闭塞病变与导丝体外化的可行性以及安全性。方法回顾性分析广东省人民医院119例CTO患者。其中,2015...目的探讨Guidezilla^(TM)延长导管在冠状动脉慢性完全闭塞病变(chronic total occlusion,CTO)行逆向经皮冠状动脉介入治疗时协助导丝通过闭塞病变与导丝体外化的可行性以及安全性。方法回顾性分析广东省人民医院119例CTO患者。其中,2015年1月至2015年10月入选80例未使用Guidezilla^(TM)延长导管的反向控制性前向与逆向内膜下寻径(controlled anterograde and retrograde sub-intimal tracking,CART)技术的患者(Non-Guidezilla组),2015年10月至2016年11月入选39例使用Guidezilla^(TM)延长导管的反向CART技术的患者(Guidezilla组)。结果本研究中反向CART技术总体成功率为84.0%(100/119)。Guidezilla组成功率(100%比76.2%,P<0.05)高于Non-Guidezilla组,差异有统计学意义;两组患者平均J-CTO评分为2.67,Guidezilla组手术困难(35.9%比15.0%,P<0.001)和非常困难(61.5%比32.5%,P<0.001)的患者比例均高于Non-Guidezilla组,差异均有统计学意义;Guidezilla组二次手术率(25.6%比63.8%,P<0.001)及开口/分叉病变比例(30.8%比62.5%,P=0.002)均低于Non-Guidezilla组,差异均有统计学意义;Guidezilla组闭塞近段刀割状(53.8%比32.5%,P=0.030)、闭塞段长度>20 mm(89.7%比72.5%,P=0.035)及闭塞段弯曲>45°(84.6%比63.8%,P=0.020)的比例均高于Non-Guidezilla组,差异均有统计学意义。结论对于长迂曲的复杂CTO患者,逆向导丝与微导管难以通过病变并进入正向指引时,Guidezilla^(TM)延长导管能提供安全有效的解决方案。展开更多
Background The Guidezilla reverse controlled antegrade and retrograde tracking("Guidezilla reverse CART")technique has become one of guidewire crossing techniques in current retrograde coronary total occlusi...Background The Guidezilla reverse controlled antegrade and retrograde tracking("Guidezilla reverse CART")technique has become one of guidewire crossing techniques in current retrograde coronary total occlusion(CTO)percutaneous coronary intervention(PCI),but has received limited study regarding long-term outcomes.Our aim is to investigate procedural and long-term outcomes in a real-world cohort of CTO patients who underwent retrograde PCI with the"Guidezilla reverse CART"technique.Methods Our study included 315 patients who underwent retrograde CTO PCI,with 86 patients treated with"Guidezilla reverse CART"technique(the Guidezilla group)at Guangdong Cardiovascular Institute from January 2015 to December 2017.The median follow-up was 1.9 years.Major adverse cardiac events(MACE)were analyzed using the Kaplan-Meier method,and independent predictors of long-term MACE were determined using a multivariable Cox model.Results Procedural success of the Guidezilla group and non-Guidezilla group were 95.3%and 82.1%,respectively(P=0.003).The procedural complications and in-hospital MACE were similar between both groups.During the 4-year follow-up,27 patients had MACE.Multivariable analysis revealed that the"Guidezilla reverse CART"technique was not associated with worse long-term clinical outcomes[hazard ratio(HR):2.11;95%CI:0.64-6.98,P=0.220].Conclusions The"Guidezilla reverse CART"technique improves the success rate in retrograde PCI of more complex CTOs and is associated with similar complication and in-hospital MACE rates.The"Guidezilla reverse CART"technique is not significantly associated with adverse clinical outcomes.展开更多
基金supported by fund from Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1–049)National High Level Hospital Clinical Research Funding(2022-NHLHCRF-LX-01-0203)
文摘Takayasu arteritis(TA)is a rare systemic vasculitis of the aorta and its primary branches,which usually occurs in young women.Due to its insidious onset and lack of specific symptoms,this disease can be easily misdiagnosed or missed.Approximately 50%of the patients having TA with pulmonary artery involvement develop pulmonary hypertension(PH).The 3-year survival rate among patients with TA-related PH is lower than that among patients with TA alone.Early balloon pulmonary angioplasty(BPA)can improve the clinical symptoms and survival of patients with stable TA.To the best of our knowledge,this is the first case reported in the English literature in which a“Guidezilla”catheter was used during BPA to treat stenosis and occlusion of the pulmonary artery caused by Takayasu arteritis(TA).
文摘目的探讨Guidezilla^(TM)延长导管在冠状动脉慢性完全闭塞病变(chronic total occlusion,CTO)行逆向经皮冠状动脉介入治疗时协助导丝通过闭塞病变与导丝体外化的可行性以及安全性。方法回顾性分析广东省人民医院119例CTO患者。其中,2015年1月至2015年10月入选80例未使用Guidezilla^(TM)延长导管的反向控制性前向与逆向内膜下寻径(controlled anterograde and retrograde sub-intimal tracking,CART)技术的患者(Non-Guidezilla组),2015年10月至2016年11月入选39例使用Guidezilla^(TM)延长导管的反向CART技术的患者(Guidezilla组)。结果本研究中反向CART技术总体成功率为84.0%(100/119)。Guidezilla组成功率(100%比76.2%,P<0.05)高于Non-Guidezilla组,差异有统计学意义;两组患者平均J-CTO评分为2.67,Guidezilla组手术困难(35.9%比15.0%,P<0.001)和非常困难(61.5%比32.5%,P<0.001)的患者比例均高于Non-Guidezilla组,差异均有统计学意义;Guidezilla组二次手术率(25.6%比63.8%,P<0.001)及开口/分叉病变比例(30.8%比62.5%,P=0.002)均低于Non-Guidezilla组,差异均有统计学意义;Guidezilla组闭塞近段刀割状(53.8%比32.5%,P=0.030)、闭塞段长度>20 mm(89.7%比72.5%,P=0.035)及闭塞段弯曲>45°(84.6%比63.8%,P=0.020)的比例均高于Non-Guidezilla组,差异均有统计学意义。结论对于长迂曲的复杂CTO患者,逆向导丝与微导管难以通过病变并进入正向指引时,Guidezilla^(TM)延长导管能提供安全有效的解决方案。
基金supported by Science and Technology Planning Project of Guangdong Province(No.2016A020216022)。
文摘Background The Guidezilla reverse controlled antegrade and retrograde tracking("Guidezilla reverse CART")technique has become one of guidewire crossing techniques in current retrograde coronary total occlusion(CTO)percutaneous coronary intervention(PCI),but has received limited study regarding long-term outcomes.Our aim is to investigate procedural and long-term outcomes in a real-world cohort of CTO patients who underwent retrograde PCI with the"Guidezilla reverse CART"technique.Methods Our study included 315 patients who underwent retrograde CTO PCI,with 86 patients treated with"Guidezilla reverse CART"technique(the Guidezilla group)at Guangdong Cardiovascular Institute from January 2015 to December 2017.The median follow-up was 1.9 years.Major adverse cardiac events(MACE)were analyzed using the Kaplan-Meier method,and independent predictors of long-term MACE were determined using a multivariable Cox model.Results Procedural success of the Guidezilla group and non-Guidezilla group were 95.3%and 82.1%,respectively(P=0.003).The procedural complications and in-hospital MACE were similar between both groups.During the 4-year follow-up,27 patients had MACE.Multivariable analysis revealed that the"Guidezilla reverse CART"technique was not associated with worse long-term clinical outcomes[hazard ratio(HR):2.11;95%CI:0.64-6.98,P=0.220].Conclusions The"Guidezilla reverse CART"technique improves the success rate in retrograde PCI of more complex CTOs and is associated with similar complication and in-hospital MACE rates.The"Guidezilla reverse CART"technique is not significantly associated with adverse clinical outcomes.
