Japanese
Title5. 人工血液(perfluorochemicals)の撰択的冠動脈造影(cineangiography)への応用
Subtitle特集/誌上シンポジウム PFC乳剤をめぐって III. PFC乳剤の臨床
Authors板岡俊成, 和田寿郎
Authors(kana)
Organization東京女子医科大学胸部外科
Journal循環制御
Volume3
Number1
Page66-77
Year/Month1982/
Article報告
Publisher日本循環制御研究会
Abstract虚血性心疾患にとって撰択的冠動脈造影は非常に有用な検査である. しかし, 従来報告されているように, 同検査において一過性・致命的な不整脈・心機能低下等1)を惹起す場合があり, 文献上では撰択的冠動脈造影による死亡率は0.05〜8%と報告2,3)され, 同検査には最大なる注意, 技術を要するものと考えられている. これら不整脈・心機能低下のおもな原因として, (1)撰択的冠動脈造影の手技および使用器具の問題, (2)使用造影剤の性質, の2点に大別される. 前者の問題点に関しては, 1974年よりM.P.Judkinsら4)が提議していることであり, 現在においては使用カテーテル材質5), 検査手技が改良され安定した検査方法となっている. 一方, 後者の使用造影剤の性状としては, (1)浸透圧6), (2)粘稠度7), (3)電解質濃度8), (4)造影剤中安定剤の性状9)等が問題となり, 心臓・血管造影時の血管痛, 熱感さらには心機能低下等が報告されている.
Practice基礎医学・関連科学
KeywordsSelective coronary arteriography, perfluorochemicals, Radio-paque medium, Myocardial hypoxia, Oxygen-supplying capacity
English
Title5. 人工血液(perfluorochemicals)の撰択的冠動脈造影(cineangiography)への応用
Subtitle
Authors板岡俊成, 和田寿郎
Authors(kana)
Organization東京女子医科大学胸部外科
JournalCirculation Control
Volume3
Number1
Page66-77
Year/Month1982/
ArticleReport
PublisherJapan Society of Circulation Control
AbstractSelective coronary arteriography is the most popular diagnostic method for ischemic heart diseases, however, is often accompanied with transient or fatal arrhythmias and hemodynamic depression. Such accidents are attributable mainly to (1) technical problems, and to (2) radio-paque media used in coronary angiography. With a view to preventing ischmia in the regional myocardium during selective coronary arteriography, we have been developing a radio-paque medium with improved oxygensupplying capacity by mixing a conventional medium(76%Urografin) with oxygen-carrying perfluorochemicals(35 w/v% Fluosol-DA). In experimental studies, it is evident that the higher the PFC concentration is in the medium, which means increase of oxygen-supplying capacity to the regional myocardium, less changes of hemodynamic and electrocardial distarbanse are brought about. In clinical studies, 16 cases have been subjected to selective coronary arteriography and in each of these cases a radio-paque medium mixed 35w/v% FDA(FDA content:10%, iodine content:260mg/mL) and a conventional radio-paque medium containing no FDA(iodine ion content:260 mg/mL) were used in selective coronary angiography. Sigma-ST values in left coronary arteriographies showed a significant differense(p<0.02) between two groups, that is, FDA containing radio-paque medium resulted in less ischemic ST-segment change:-0.4±0.14mm(p<0.01), as compared to-1.23±0.30mm(p<0.001) in using the conventional medium alone. We believe it can be developed into a far safer means for selective coronary arteriography.
PracticeBasic medicine
KeywordsSelective coronary arteriography, perfluorochemicals, Radio-paque medium, Myocardial hypoxia, Oxygen-supplying capacity

【全文PDF】