血管内超声指导切割球囊在冠状动脉重度钙化病变介入治疗中有效性及安全性的评价  

Efficacy and Safety Evaluation on Cutting Balloon Angioplasty for Treating the Patients With Severe Coronary Calcification Lesions Under Intravascular Ultrasound Guidance

作　　者：汤喆[1] 白静[1] 王禹[1] 苏绍萍[2] 马清华[3] 刘谟焓[1] 田进文[1] 高磊[1] 宋康兴 李彦华[1] 

机构地区：[1]中国人民解放军总医院老年心血管病研究所,北京市100853 [2]中国人民解放军总医院门诊部,北京市100853 [3]山东省临沂市沂水中心医院心血管内科

出　　处：《中国循环杂志》2014年第1期12-15,共4页Chinese Circulation Journal

基　　金：中国人民解放军总医院苗圃基金(基金编号:13KMZ02)

摘　　要：目的:利用血管内超声评价切割球囊在冠状动脉重度钙化病变介入治疗中的有效性及安全性。方法:自2012-03至2013-03在我中心行冠状动脉造影及血管内超声检查的至少有一处病变为重度钙化的110例冠心病患者,随机分为常规球囊组54例及切割球囊组56例。在支架置入前及置入后均行血管内超声检查,观察术中操作特征,评价支架置入即刻效果及术中即刻并发症。观察记录患者院内、术后1个月和6个月的主要不良心脏事件。结果:两组支架置入前钙化弧度、钙化长度比、最小管腔面积,差异均无统计学意义(P>0.05)。切割球囊组支架置入后最小支架面积、即刻管腔获得面积均大于常规球囊组,差异均有统计学意义(P<0.05)。两组术后出现夹层及血管丢失的比例,差异无统计学意义(P>0.05)。两组院内及术后1个月和6个月的主要不良心脏事件,差异无统计学意义(P>0.05)。结论:在重度钙化病变中使用切割球囊可以有效增加支架置入后的管腔获得,未见介入相关并发症明显增加。Objective： To evaluate the efficacy and safety on cutting balloon angioplasty for treating the patients with severe coronary calcification lesions under intravascular ultrasound （IVUS） guidance. Methods： A total of 110 consecutive patients with at least 1 severe coronary calcification lesion confirmed by coronary angiography and IVUS in our hospital from 2012-03 to 2013-03 were studied. The patients were divided into 2 groups. General balloon （BA） group, n=54 and Cutting balloon （CB） group, n=56. IVUS was performed before and after percutaneous coronary intervention （PCI） to observe the operational characteristics and to evaluate the immediate efficacy with complications. The MACE for in-hospital, 1 month and 6 months after PCI were recorded in all patients. Results： Before PCI, the mean ratio of calcification arc to length and the minimum lumen area were similar between 2 groups, P〉0.05. After PCI, compared with BA group, CB group showed larger minimum lumen area and larger immediate lumen gain area, P〈0.05. The occurrence of post PCI dissection, vessel losing and the in-hospital, 1 month and 6 months post PCI MACE were similar between 2 groups, P〉0.05. Conclusion： The cutting balloon angioplasty could effectively increase the post PCI lumen gain without increasing the complication in patients with severe coronary calcification lesions.

关 键 词：冠状动脉钙化 切割球囊 血管内超声 经皮冠状动脉介入治疗 

分 类 号：R54[医药卫生—心血管疾病]