Sodium Chloride Physiological Saline Solution Versus Water Preparations Injectable in the Use of Shockwave Intravascular Lithotripsy: A Single-Center Experience.

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Quentin Landolff, Matthieu Godin, Alexandre Canville, Benjamin Honton, Jacques Monsegu, Marine Quillot, Jacques Berland, Rene Koning, Nicolas Amabile
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引用次数: 0

Abstract

Background: Shockwave intravascular lithotripsy (IVL) coronary system is a very useful new technology for de novo severely calcified coronary artery plaques before percutaneous coronary intervention (PCI). The device uses a semi-compliant low-pressure balloon, integrated into a sterile catheter, to deliver by vaporizing fluid an expanding bubble that generates high-pressure ultrasonic energy by waves that create multiplane longitudinal micro-macro fractures in calcified plaques, which facilitate optimal stent placement and expansion, and luminal gain.

Methods: The use of Shockwave IVL coronary system in our cardiac catheterization laboratory (Cath lab) at the "Clinique Saint-Hilaire" in Rouen, France, started in March 2019, with 42 procedures performed since this date: two patients in 2019, two patients in 2020, seven patients in 2021, 23 patients in 2022, and eight patients since the beginning of 2023.

Results: We had experienced problems at the beginning of our activity for the first 11 patients (two patients in 2019, two patients in 2020, and seven patients in 2021): after less than five pulses, the shock therapy stopped. We used initially for Shockwave IVL semi-compliant low-pressure integrated balloons a mixture of 50% contrast and 50% water preparations injectable (PPI). After changing water PPI by sodium chloride physiological saline solution, we never encountered this problem again for the following 31 patients (23 patients in 2022, and eight patients since the beginning of 2023). In fact, the proper functioning of Shockwave IVL system requires ions in balloon mixture in addition to the contrast. It is thanks to the ions contained in sodium chloride physiological saline solution that the spark necessary for shocks delivery after balloon inflation is produced.

Conclusions: Water PPI or sodium chloride physiological saline solution is used in angioplasty balloons in a lot of Cath labs worldwide. It is therefore essential to disseminate in the worldwide Cath lab the obligation to put in Shockwave IVL semi-compliant low-pressure integrated balloons sodium chloride physiological saline solution, rather than water PPI for optimal performance, and the importance of Shockwave Medical reporting this to interventional cardiologists.

Abstract Image

Abstract Image

在冲击波血管内碎石术中使用氯化钠生理盐水溶液与注射水制剂:单中心经验。
背景:冲击波血管内碎石(IVL)冠状动脉系统是一种非常有用的新技术,用于经皮冠状动脉介入治疗(PCI)前新发严重钙化的冠状动脉斑块。该设备使用半兼容的低压球囊,整合到无菌导管中,通过汽化液体产生一个膨胀的气泡,通过波浪产生高压超声能量,在钙化斑块中产生多平面纵向微宏观断裂,从而促进最佳支架放置和扩张,并获得管腔增益。方法:我们在法国鲁昂“圣伊莱尔诊所”的心导管实验室(Cath lab)于2019年3月开始使用冲击波IVL冠状动脉系统,自该日起共进行了42例手术:2019年2例,2020年2例,2021年7例,2022年23例,2023年初至今8例。结果:前11例患者(2019年2例,2020年2例,2021年7例)在活动开始时就遇到了问题:在不到5次脉冲后,休克治疗停止。我们最初使用的冲击波IVL半顺从低压一体化气球是50%造影剂和50%可注射水制剂(PPI)的混合物。在用氯化钠生理盐水溶液改变水PPI后,以下31例患者(2022年23例,2023年初至今8例)没有再出现此问题。事实上,冲击波IVL系统的正常工作除了需要造影剂外,还需要球囊混合物中的离子。正是由于氯化钠生理盐水中所含的离子,才产生了气球充气后冲击传递所需的火花。结论:国内外许多导管实验室均采用水PPI或氯化钠生理盐水溶液作为血管成形术球囊。因此,有必要在世界范围内的导管室宣传在冲击波IVL半合规低压集成气囊中放入氯化钠生理盐水溶液,而不是水PPI以获得最佳性能的义务,以及冲击波医学向介入心脏病专家报告这一情况的重要性。
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来源期刊
Cardiology Research
Cardiology Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.50
自引率
0.00%
发文量
42
期刊介绍: Cardiology Research is an open access, peer-reviewed, international journal. All submissions relating to basic research and clinical practice of cardiology and cardiovascular medicine are in this journal''s scope. This journal focuses on publishing original research and observations in all cardiovascular medicine aspects. Manuscript types include original article, review, case report, short communication, book review, letter to the editor.
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