血管内超声评价支架置入效果及指导高压球囊后扩张术的应用价值——附45例分析  

The application of intravascular ultrasound in evaluating stent implantation and guiding high-pressure balloon post-inflation

作　　者：徐峰[1] 陈玉国[1] 张运[2] 李瑞建[1] 孙祎[1] 张梅[2] 李继福[2] 李贵双[2] 

机构地区：[1]山东大学心血管病研究中心山东大学齐鲁医院急诊科及胸痛中心,250012 [2]山东大学心血管病研究中心山东大学齐鲁医院心内科,250012

出　　处：《新医学》2007年第6期357-360,共4页Journal of New Medicine

基　　金：卫生部临床学科重点基金项目(20012943);山东省自然科学基金项目(2002BB1CJA1)

摘　　要：目的：探讨血管内超声（intravascular ultrasound,IVUS）检查评价药物洗脱支架置入术效果及指导高压球囊后扩张术的应用价值。方法：对45例需行支架置入术治疗的ACS患者76处病变置入药物洗脱支架（drug-eluting stent,DES）,在支架置入前后进行冠状动脉造影（coronary angiography,CAG）及IVUS检查,对未达到IVUS检查视为理想的支架置入标准者再采用高压球囊后扩张术,并用IVUS评价支架置入的效果。结果：45例患者76处病变置入DES后行CAG检查,结果所有支架均达到理想的支架置入标准;行IVUS检查,结果76处病变中有43处（57%）达到IVUS检查视为理想的支架置入标准,33处（43%）未达到IVUS检查视为理想的支架置入标准。对这33处病变行高压球囊后扩张术,结果25处病变达到IVUS检查视为理想的支架置入标准,总理想达标率由之前的57%上升至89%（P〈0.01）。随访1-10个月,中位数5个月,再发心绞痛2例。结论：IVUS在评价支架置入效果及指导高压球囊后扩张术方面具有重要的临床实用价值,可进一步提高高压球囊后扩张术及评价支架置入的疗效。Objective： To investigate the application of intravascular ultrasound （IVUS） in evaluating drug-eluting stent implantation and guiding high-pressure balloon post-inflation in patients with acute coronary syndrome （ACS）. Methods： Drug-eluting stents were implanted in 76 lesions of 45 patients with ACS. All patients were examined by coronary angiography （CAG） and IVUS before and after stent implantation. If IVUS criteria of optimal stent deployment were not met, post-inflation at higher pressure and reassessment with IVUS were performed. Results： The optimal criteria of CAG were achieved in 76 lesions of 45 patients with ACS, but optimal criteria of IVUS were not obtained in thirty-three lesions （43%） and were treated with high-pressure balloon post-inflation. Then another twenty-five lesions obtained the optimal criteria of IVUS, and the frequency of achieving the optimal criteria of IVUS increased from 57% to 89% （P 〈 0. 01 ）. During follow-up of 1 - 10 （median 5） months. There were two patients of recurrent angina. Conclusion ： There is important clinical practical value that application of IVUS in evaluating stent implantation and guiding high-pressure balloon post-inflation.

关 键 词：血管内超声检查 高压球囊后扩张术 药物洗脱支架 冠状动脉内支架置入术 急性冠状动脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]