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首页> 外文期刊>Cardiology Research >The Safety and Efficacy of Guidezilla Catheter (Mother-in-Child Catheter) in Complex Coronary Interventions: An Observational Study
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The Safety and Efficacy of Guidezilla Catheter (Mother-in-Child Catheter) in Complex Coronary Interventions: An Observational Study

机译：指南导管（儿童导管）在复杂冠状动脉干预中的安全性和有效性：观察研究

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Background: Lesion characteristics (anatomy, calcification, tortuosity and angulation), vessel morphology, and lack of support add complexity of coronary intervention. Guidezilla catheter, acting as an extension of guide catheter system (mother-in-child catheter), helps to overcome these complexities by enhancing backup during complex intervention.Methods: The present retrospective, single-center study included 13,157 consecutive patients who underwent percutaneous coronary intervention (PCI) through both transfemoral and transradial routes from January 2015 to July 2019 at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India among which Guidezilla? catheter (Boston Scientific, Natick, MA, USA) was used in 156 patients. Study endpoints were target lesion crossing, procedural success, and complications. The clinical, angiographic and procedural data of all 156 patients were evaluated to assess safety and efficacy of Guidezilla extension catheter (GEC).Results: The mean age of the enrolled patients was 61.2 ± 8.67 years. Type-C lesion was commonest (69.9%) followed by B2 (22.4%) and B1 (7.7%). The commonest indication for its use was tortuosity (30.1%) followed by calcification (21.1%), angulation (18.8%), chronic total occlusion (17.9%), distally located lesion (8.3%), and anomalous origin of vessel in 3.8%. The right coronary artery (39.2%) was most commonly intervened artery followed by left anterior descending (LAD) (30.8%), left circumflex (LCX) (19.9%), multivessels (7.6%), and saphenous vein graft in 2.5%. The mean depth of intubation was 4.2 ± 1.9 cm. Mean diameter of stents was 34.2 ± 14.4 mm while mean length of stents was 31.2 ± 10.2 mm. Lesions were modified using aggressive pre-dilatation in 87.8%, followed by cutting balloon in 10.9%. GEC was delivered across the lesion using buddy wire technique (9.6%), balloon-assisted tracking (BAT) in 30.1%, and balloon-assisted sliding and tracking (BLAST) in 4.5% of patients. Stent implantation was successful in 151 out of 156 patients with success rate of 96.7%. Overall failure rate was 3.3% which was contributed by extreme tortuosity, angulation, and severe calcification. Guidezilla-associated procedural complication (dissection, stent dislodgement, shaft breakage) were reported in three patients (1.9%) who were successfully managed.Conclusion: s Guidezilla system acting as mother-in-child extension catheter is a safe and effective tool which provides additional backup support and increases success rate of PCI for complex coronary lesions.
机译：背景：病变特征（解剖，钙化，曲折和角度），血管形态，缺乏支持增加了冠状​​动脉干预的复杂性。指南导管，作为导管系统（儿童母导管）的延伸，有助于通过在复杂干预期间提高备份来克服这些复杂性。方法：目前的回顾性，单中心研究包括13,157名连续冠状动脉的患者干预（PCI）通过2015年1月至2019年7月在LPS心脏病学会，GSVM研究所的经罚金和跨大型路线医学院，Kanpur，北方邦，印度在哪个Guidzilla？在156名患者中使用了导管（波士顿科学，Natick，MA，MA）。研究终点是目标病变交叉，程序成功和并发症。评估所有156名患者的临床，血管造影和程序数据，以评估指南延伸导管（GEC）的安全性和有效性。结果：注册患者的平均年龄为61.2±8.67岁。 C型失病是最常见的（69.9％），然后是B2（22.4％）和B1（7.7％）。其使用的最常见的迹象是曲折性（30.1％），然后进行钙化（21.1％），角度（18.8％），慢性总闭塞（17.9％），远位于3.8％的血管异常血管。右冠状动脉（39.2％）最常介入动脉，然后左侧下降（LAD）（30.8％），左环（LCX）（19.9％），多血管（7.6％）和隐静脉移植物中的2.5％。插管的平均深度为4.2±1.9厘米。支架的平均直径为34.2±14.4毫米，平均支架长度为31.2±10.2毫米。使用87.8％的激进预扩张进行修饰病变，然后在10.9％的切割球囊中切割。 GEC使用Prydy Wire技术（9.6％），气球辅助跟踪（BAT）在30.1％，并在4.5％的患者中辅助滑动和跟踪（BLAST）的气球辅助跟踪（BAT）递送。 151名患者中的151名患者中成功率为96.7％，植入支架植入成功。总体故障率为3.3％，这是由极端曲折，角度和严重钙化贡献。在成功管理的三名患者（1.9％）中报告了指南相关的程序并发症（解剖，支架脱裂，轴断裂）。结论：义指南系统作为母婴延伸导管是一种安全有效的工具额外的备份支持并提高CPI的成功率为复杂的冠状病变。

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