导管导管延伸的使用与慢性全闭性皮肤穿透冠状动脉干预的更高的程序成功有关
Evandro M Filho1, Gustavo N Araujo2,3, Guilherme P Machado4
1Santa Casa de Misericórdia de Maceió, Maceió, Brazil.
概括
导管导管延伸 (GCE) 改善了慢性全闭性皮肤冠状动脉干预 (CTO PCI) 的程序成功. 虽然GCE用于复杂的病例,但它们不会增加死亡或中风等不良结果.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 导导管延伸器 (GCEs) 增强支并促进穿皮冠状动脉干预 (PCI) 期间的装置输送.
- 然而,人们对使用GCE的攻击性仪器可能增加并发症风险存在担忧.
研究的目的:
- 评估GCE对手术成功和并发症率对慢性全闭症 (CTO) PCI患者的影响.
- 为了比较在CTO PCI期间接受和不接受GCE的患者之间的结果.
主要方法:
- 分析来自多中心LATAM CTO注册表的数据,包括2010年8月至2021年8月3049名患者.
- 程序成功定义为<30%的残留狭窄和TIMI 3远程流. 主要不良心脏和脑血管事件 (MACCE) 包括死亡,心肌梗塞,目标血管再血管化和中风.
- 使用倾向分数匹配 (PSM) 来平衡GCE和非GCE组之间的基线特征.
主要成果:
- 在14.5%的患者中使用了GCE,通常是老年人,具有更多的并发症和复杂的冠状动脉解剖学 (较高的J-CTO得分).
- 在PSM后,GCE组 (87.7%) 的程序成功率明显高于非GCE组 (80.5%),p=0.007.
- 冠状动脉穿孔,出血,住院死亡和MACCE的发生率在PSM后的组之间是相似的.
结论:
- 在当代CTO PCI中,GCE的使用与改善的程序成功有关.
- 尽管在具有更复杂解剖和并发症的患者中使用,但GCEs并没有导致不良结果的发病率更高.
- 在复杂的CTO PCI中,GCE代表了增强程序成功的宝贵工具,而不会增加重大并发症.
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