扩张微导管在慢性完全闭塞病变中的应用价值--经桡动脉正向介入治疗

目的：评价135 cm扩张微导管（corsair导管，Asahi Intec Co，Japan）在冠状动脉慢性完全闭塞（chronic total occlusion，CTO）病变经桡动脉正向经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）中的有效性及安全性。方法回顾性入选了本中心2010年6月至2014年2月81例经桡动脉途径应用135 cm扩张微导管进行正向导引钢丝技术治疗的CTO病变患者，分析正向CTO-PCI成功率、扩张微导管通过闭塞病变成功率、球囊导管通过闭塞病变情况及导引钢丝通过闭塞病变情况，并观察住院期间不良事件发生率。结果81例应用135 cm扩张微导管经桡动脉正向介入治疗的患者中，66例患者正向导引钢丝通过CTO病变，65例患者正向CTO-PCI成功，成功率为80.2%；另有8例成功进行逆向导引钢丝介入治疗，总体PCI成功率90.1%。66例正向导引钢丝通过闭塞病变后，135 cm扩张微导管成功通过闭塞病变56例（84.8%）；扩张微导管通过闭塞病变后，球囊导管的使用数量为1.3个，显著低于扩张微导管未通过闭塞病变患者。66例正向导引钢丝通过闭塞病变的患者中，应用Fielder XT导引钢丝34例（51.5%）。住院期间随访未见扩张微导管嵌顿、折断、头端受损、血管穿孔等不良事件发生，无严重不良心脏事件发生。结论应用扩张微导管经桡动脉途径行正向CTO-PCI治疗是安全、有效的，可以简化介入治疗操作步骤，减少球囊导管等器械的使用，提高CTO病变介入治疗的手术成功率。

Evaluation the safety and efifcacy of corsair microcatheterin the recanalization for coronary chronic total occlusion with transradialantegrade approach

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention （PCI） for coronary chronic total occlusion （CTO） with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter （Asahi Intec Co, Japan） and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 （90.1%） patients. Crossing the CTO body with Corsair microcatheter was found in 56（84.8%） patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross （1.3±0.6 per patient versus 2.8±1.2per patient, P 〈 0.05）. The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.