CAG操作技巧.ppt

After CAG, 6 Fr GC cannot pass. Angiography showed CAG via radial collateral Use .014” coronary wire to overcome radial tortuosity Vessel was straightened after guidewire passing The vessel features in the elderly Age How to overcome tortuous brachiocephalic trunk Shift to a stiffer wire Gentle manipulation with deep breathe Pull the wire into the shaft of the catheter in order to facilitate torquing for coronary cannulation. For severe tortuous subclavian artery, switch to a stiff 0.038 Cook wire. Double edge swordhydrophilic guide wire Facial paralysis Mediastinal hematoma Usually originates from smaller injured vessels rather than from the aortic tear. Int J Cardiol. 2007 Jul 26; Double edge swordhydrophilic guide wire Patient had hematoma after PCI Selective right superior thyroid arteriography demonstrates extravasation of contrast. After gelfoam embolization, the right superior thyroid artery was occluded and extravasation of the contrast was no longer visible. Double edge swordhydrophilic guide wire Catheter kinking via radial approach Withdraw the twisted GC Compartment syndrome Hemostasis device should be removed Use Elastic bandage suspension method Ice bag How to treat… Catheterization and Cardiovascular Interventions 75:366–368 (2010) Open fasciotomy is indicated when the intracompartmental pressure reaches a cutoff value of 30 mm Hg. Watch out for the cath tip ! Tiger went to the conus branch, patient got VF during injection. Be careful… Vision without action is a daydream.Action without vision is a nightmare. * 常见各种SVG开口的位置。 * 不同SVG开口和走向需选用不同的指引导管。 Is the most simple to understand and use * US ~5% Radial (LifeScience International, WW VC Report 2008, p 6-40) Europe 25% Radial (MRG 2007 Global VC Report) Japan 45% Radial (MRG 2007 Global VC Report) MRG2007: # Total Procedure Volumes US 5,320,000 Europe 2,265,000 Japan 1,352,000 Global 8,936,000 (sum) Weighted average was taken to estimate Global radial %.