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Objective To summarizes the experiences and technique of complex transradial percutaneous coronary intervention (PCI) using sheathless guide catheter (Sheathless Eaucath, ASAHI) for 60 patients with coronary heart disease. Methods Retrospectively analyzed the data from 60 patients received PCI using sheathless guide catheter. Results PCI were performed on a total of 60 patients with complex lesions. Angiographic success was achieved in 95.0%and failed in three patients with CTO. 7 patients were with left main lesions, and 32 patients were with bifurcation lesions(including 7 patients with left main lesions and 2 patients with CTO), and 13 patients were with CTO, and the other 17 patients were with tortuous and calcified lesions. Sheathless guide catheters of 7.5Fr were used for PCI in all patients, and all catheters successfully passed through the radial artery and were put in place. No other vascular complications associated with the use of the catheter occurred. Sheathless guide catheters were respectively JL(8 patients), PB(2 patients), AL(2 patients), and JR(1 patient) in 13 patients with CTO, and were respectively JL(8 patients), JR(6 patients), SPB(2 patients), AL(1 patient) in 17 patients with tortuous and calcified lesions. JL or JR were used in all 32 patients with bifurcation. Conclusions Use of the Sheathless of 7.5 Fr is safe and feasible, and allows complex interventions to be undertaken transradially with a high success rate.
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@#Objective To investigate the safety and efficacy of protective measures(hydration treatment)during perioperative period of interventional therapy for renal function of gerontic patients with coronary artery disease(CAD)complicated by chronic renal insufficiency(CRI).Methods The relation between hydration therapies and the renal function of 168 CAD patients(≥60 years old)complicated by CRI were analyzed.These patients were divided into three groups:in the group A,patients underwent selective coronary angiography(SCA)with conventional treatment during interventional perioperative period(IPP);in the group B,patients underwent SCA and treated with the NaCl plus low dose NaHCO3 during IPP;in the group C,patients underwent percutaneous coronary intervention(PCI),and meanwhile treated with the same dose NaCl and NaHCO3 as the group B during IPP.Results Coronary interventions were successful in all 168 patients.Contrast medium associated nephropathy(CAN)was found in 30 patients,and incidences of the CAN were 17(27.4%)in the group A,3(7.5%)in the group B and 10(15.2%)in the group C,respectively.The accompanying diseases and characteristics of the patients also effected the incidence of CAN:the CAN incidence of patients with hyperlipidemia was significantly higher than that with normal cholesterol(P<0.001);patients with diabetes was significantly higher than that with normal serum glucose(P<0.001);patients with stenosis of renal artery was significantly higher than that with normal renal artery(P<0.001);patients with heart failure(grade Ⅲ～Ⅳ)was significantly higher than that with the grade Ⅰ～Ⅱ(P<0.001).Conclusion The hydration treatment with the NaCl plus low dose NaHCO3 during IPP can protect renal function and increase tolerance for gernotic CAD patients complicated by CRI during IPP,and improve prognosis.
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@# As a multipotential stem cell, adipose-derived mesenchymal cell presents similar characters with bone marrow-derived menchymal stem cell in morphology and biology, and has the ability of directional differentiation to the all three germ layers. The adipose-derived mesenchymal stem cell could be harvested conveniently with slighter wound, and has a broad prospect in cell therapy and tissue engineering.