摘要
目的探讨应用磁导航引导进行冠状动脉介入治疗的有效性和安全性。方法入选在磁导航室经冠状动脉造影确诊并符合介入治疗适应证的冠状动脉病变。经股动脉或桡动脉径路，采用磁导航引导进行冠状动脉介入治疗，记录靶病变特征、手术过程、X线暴露时间、x线暴露量和相关并发症。用Stata9．2软件进行数据分析。结果自2006年4月至2008年6月共入选冠心病患者121例，治疗靶病变138处，其中A型病变30处、B1型病变50处、B2型病变36处、C型病变22处（包括闭塞病变7处）。靶病变平均狭窄程度（85．3±10．0）％、平均长度（21．1±10．0）mm。在磁导航引导下，磁导丝通过病变134处，病变通过率为97．1％。磁导丝置人过程中X线暴露时间（55．9±35．4）s、X线暴露量（98．0±86．1）mGy／（490．04-422．2）μGym2、对比剂用量（8．0±5．4）ml。在磁导丝通过的靶病变处共置入支架164枚。未发生与磁导航系统相关的并发症。磁导丝未能通过的靶病变共4处，其中2处为慢性完全闭塞（CTO）病变，另2处为伴有钙化的次全闭塞病变。结论应用磁导航引导进行常规的冠状动脉介入治疗是可行的，磁导丝病变通过率高，安全性好。CTO病变和伴有钙化的次全闭塞病变不适宜应用磁导航系统进行介入治疗。
Objective To investigate the efficacy and safety of the magnetic navigation system used in the real world percutaneous coronary artery intervention. Methods All lesions detected by the coronary artery angiography in the magnetic-navigation catheter lab indicated for percutaneous coronary artery intervention （PCI） were included and treated under the guidance of the magnetic navigation system. The characteristics of the target lesion, process of the procedure, time and dosage of the X-ray exposure, and procedure-related complication were recorded and analyzed. Results One hundred and twenty one patients with 138 lesions were recruited and intervened by PCI during the period from April 2006 to June 2008. Thirty lesions were classified as type A, 50 as type B1, 36 as type B2, 22 as type C （including seven total occlusions）. The average stenosis of the target lesions was （85. 3± 10.0）%, mean length was （21.1± 10.0）mm. Under the guidance of the magnetic navigation system, 134 target lesions were passed by the magnetic guide-wires, the lesion passing ratio was 97.1%. The X-ray exposure time, X-ray dosage and the contrast volume used during the period of the wire placement were （55.9 ± 35.4） seconds, （98.0 ± 86. 1 ） mGy/（490. 0 ±422.2） μGym2 and （8.0 ±5.4）ml, respectively. A total of 164 stents were implanted in the vessels where the target lesions were passed by the magnetic wires. There was no magnetic navigation system associated complication. Magnetic guide-wires failed to pass four target lesions, two of which were chronic total occlusions （CTOs）, and the other two were calcified subtotal occlusions. Conclusions It is feasible and safe to adopt the magnetic navigation system for the real-world coronary artery intervention. The magnetic guide-wire possesses a high lesion-passing ratio. The CTOs and calcified subtotal occlusions are not ideal lesions for use of the magnetic navigation system.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2010年第3期243-247,共5页
Chinese Journal of Cardiology
基金
基金项目：江苏省“六大人才高峰”第五批高层次人才项目
南京医科大学第一附属医院新技术引进项目
关键词
冠状动脉疾病
血管成形术
经皮
经冠状动脉
磁导航系统
Coronary disease
Angioplasty, transluminal, percutaneous coronary
Magnetic navigation system
