不同径路行冠状动脉内旋磨术治疗重度钙化病变的对比研究  

Efficacy of transradial coronary rotational atherectomy in the treatment of heavily calcified lesions

作　　者：尤威[1] 叶飞[1] 陈绍良[1] 吴志明[1] 张俊杰[1] 田乃亮[1] 林松[1] 刘志忠[1] 许田[1] 王蓉[1] 徐海梅[1] 刘玲玲[1] 

机构地区：[1]南京医科大学附属南京医院南京市第一医院心内科,江苏南京210006

出　　处：《安徽医药》2013年第6期963-965,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的对照研究经桡动脉和股动脉途径行冠状动脉内旋磨术(RA)治疗重度钙化病变的安全性和有效性。方法回顾分析2008年1月—2012年9月期间,我院对107例行冠状动脉介入治疗患者术中发现重度钙化、球囊无法充分扩张或支架无法通过的病变联合RA治疗,按介入径路不同,分为TRI组(经桡动脉途径,n=59)和TFI组(经股动脉途径,n=48),观察两组的有效性:旋磨成功率、支架植入成功率、术后平均卧床时间、平均住院天数等,安全性:术中和围手术期并发症发生率、住院期间及术后一年的临床主要不良心脏事件(MACE)的随访结果。结果桡动脉组和股动脉组的RA治疗的成功率均为100%(NS),支架植入成功率(100%和97.9%,P=0.265)、旋磨术后即刻总体并发症(15.3%和18.2%,P=0.675)、支架术后即刻总体并发症发生率(3.4%和4.2%,P=0.833)、住院期间MACE发生率(7.9%和16.7%,P=0.156)和一年随访的MACE发生率(3.4%和6.0%,P=0.516)差异无显著性,但桡动脉组在穿刺总体并发症发生率(3.4%和18.8%,P=0.009)、术后桡动脉组平均卧床时间(9.1±18.0)h和(38.4±25.8)h,P<0.001、平均住院天数(3.8±1.5)d和(5.3±1.7)d,P<0.001,显著优于股动脉组。结论经桡动脉途径行冠脉内旋RA治疗重度钙化病变同股动脉途径同样安全有效,而病人耐受性更佳。Objective To compare the safety and efficacy between TRI and TFI in coronary rotational atherectomy for the treatment of heavily calcified lesions. Methods From January 2008 to September 2012,107 consecutive patients with heavily calcified lesions who underwent rotational atherectomy in our hospital were enrolled in this retrospective study. Patients were divided according to the vascular approach into two groups ：transradial approach（TRI） and transfemoral approach （TFI）. We compared the success rates of RA and stent- ing, rates of complication during perioperations, average time of lying in bed and hospitalization, MACE during hospitalization and after one year follow up. Results There were no differences in success rate of RA and stenting（ 100% vs 97.9% ,P = 0. 265 ）, RA and stent- ing complications （ 15.3 % ws 18.2% , P = 0.675 ;3.4% vs 4.2% , P = 0.833 ）, MACE during hospitalization and after one year follow up （7.9% vs 16.7% ,P = 0. 156 ;3.4% vs 6.0% ,P = 0.516）. But transradial rotational atherectomy was associated with a decrease in ac- cess site complications （3.4% vs 18.8% ,P =0. 009） ,average time of lying in bed and hospitalization （P 〈0. 001 ）. Conclusions Ro- tational atherectomy through TRA is feasible, and its efficacy and safety is comparable to the TFA, and better accepted by patients.

关 键 词：桡动脉 冠状动脉 内旋磨术 

分 类 号：R541.4[医药卫生—心血管疾病]