血管内超声指导下零对比剂行经皮冠状动脉介入治疗Contrast-free coronary intervention using intravascular ultrasound guidance
温尚煜,何峰,李永辉,于宏颖,王柏颖,黎辉
摘要(Abstract):
目的评价血管内超声(IVUS)指导下零对比剂经皮冠状动脉介入治疗的可行性和安全性。方法入选2016年10月至2020年4月于大庆油田总医院和天津第四中心医院住院的8例冠心病患者中,在冠状动脉造影或前1次经皮冠状动脉介入治疗(PCI)时发生对比剂过敏,无法再次应用对比剂进行介入诊断和治疗者,在IVUS指导下零对比剂完成介入治疗。结果 8例患者介入治疗术中未使用对比剂,参考前1次造影结果,零对比剂导引导管、导丝到位,在IVUS指导下完成病变评估、确定介入治疗部位、支架尺寸选择、置入支架后效果评估。未发生手术相关并发症,手术即刻成功率为100%。结论适当选择的对比剂过敏和严重肾功能不全患者可以在IVUS指导下零对比剂完成PCI。
关键词(KeyWords): 经皮冠状动脉介入治疗;血管内超声;零对比剂
基金项目(Foundation):
作者(Author): 温尚煜,何峰,李永辉,于宏颖,王柏颖,黎辉
参考文献(References):
- [1]Goldenberg I,Chonchol M,Guetta V.Reversible acute kidney in jury following contrast exposure and the risk of long‐term mortality.Am J Nephrol,2009,29(2):136-144.
- [2]Jose?MJ,Cristiano G,Paulo S,et al.Intravascular ultrasound guidance to minimize the use of iodine contrast in percutaneous coronary intervention:the MOZART randomized controlled trial.JACC Cardiovasc Interv,2014,7(11):1287-1293.
- [3]Ali ZA,Karimi Galougahi K,Nazif T,et al.Imaging-and physiology-guided percutaneous coronary intervention without contrast administration in advanced renal failure:a feasibility,safety,and outcome study.Eur Heart J,2016,37(40):3090-3095.
- [4]苏彦宾,荆全民,赵昕,等.放射影像及实时血管内超声指导下零造影剂冠状动脉介入治疗临床应用分析.临床军医杂志,2019,47(10):1035-1037.
- [5]汤喆,王梅,王晓,等.血管内超声指导的零对比剂冠状动脉介入治疗一例.中华心血管病杂志,2019,47(7):572-574.
- [6]林海龙,郑晓群,马义丽,等.血管内超声指导下无对比剂置入冠状动脉支架一例.中国介入心脏病学杂志,2015,23(9):529-530.
- [7]Gupta A,Neupane S,Basir M,et al.Zero-iodinated contrast retrograde percutaneous coronary interventions of chronic total occlusions using gadolinium and imaging guidance:a case report of a patient with severe anaphylaxis to iodinated contrast.Eur Heart JCase Rep,2020,4(3):1-7.