本文選題：Ikari + left指引導管��； 參考：《臨床心血管病雜志》2017年07期

【摘要】：目的:在右冠狀動脈(冠脈)起源異常的患者中,分析Ikari left指引導管尋找異常右冠開口的優(yōu)勢。方法:回顧2010-07-2014-07廈門大學附屬第一醫(yī)院心內科收治的60例非ST段抬高急性冠脈綜合征合并右冠起源異常的患者,均在Ikari left指引導管的指引下成功尋找到右冠開口,其中30例為經皮冠脈介入(PCI)術治療右冠病變,另外30例為右冠冠脈造影術。結果:4年內共計820例非ST段抬高急性冠脈綜合征中有80例合并右冠起源異常,發(fā)生率9.76%,其中30例在Ikari left指引導管的指引下完成起源異常的右冠狹窄病變PCI術,發(fā)生率為3.66%;另外30例患者右冠為非犯罪血管,2例起源于左冠竇,1例起源于主動脈前壁,均在該指引導管下成功找到右冠開口。其余20例患者均為單支冠脈,右冠為回旋支中段或遠段發(fā)出的分支,均在左冠造影的同時診斷。觀察以上患者12個月,均無再發(fā)心絞痛,無心肌梗死、心力衰竭、心源性猝死、再次入院行冠脈血管化治療等主要心血管事件出現。結論:Ikari left指引導管的獨特設計結構在尋找起源異常的右冠開口時有著明顯的優(yōu)勢,同時能安全有效地運用在這些右冠病變的PCI術中。
[Abstract]:Aim: to analyze the advantage of Ikari left guiding catheter in finding abnormal right coronary opening in patients with abnormal origin of right coronary artery (RCA). Methods: a total of 60 patients with non-ST-segment elevation acute coronary syndrome complicated with abnormal origin of right coronary artery were treated in Department of Cardiology, Xiamen University affiliated to Xiamen University, 2010-07-2014-07. Under the guidance of Ikari left catheter, the right coronary opening was found successfully. 30 cases were treated by percutaneous coronary intervention (PCI) and 30 cases by right coronary angiography. Results: of the 820 cases of non-ST-segment elevation acute coronary syndrome, 80 cases were complicated with abnormal origin of right coronary artery, the incidence rate was 9.76.The 30 cases underwent PCI procedure with abnormal origin of right coronary stenosis under the guidance of Ikari left catheter. In the other 30 patients, the right coronary artery originated from the anterior wall of the aorta in 1 case, and the right coronary orifice was successfully found under the guide catheter. All the other 20 patients were single coronary artery and the right coronary artery was the middle or distal branch of the circumflex branch. All the patients were diagnosed by left coronary angiography at the same time. After 12 months, no recurrent angina pectoris, no myocardial infarction, heart failure, sudden cardiac death, readmission coronary artery vascularization and other major cardiovascular events occurred. Conclusion the unique design structure of the left guiding catheter has obvious advantages in finding the right coronal orifice with abnormal origin, and it can be safely and effectively used in the PCI operation of these right coronal lesions.
【作者單位】： 廈門大學附屬第一醫(yī)院心內科;福建醫(yī)科大學第一臨床醫(yī)學院心內科;
【分類號】：R541.4

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