冠状动脉内旋磨术治疗前降支球囊无法通过的慢性重度钙化病变  

作　　者：唐玉龙[1] 岳乐[1] 李迪[1] 温尚煜[1] 黎辉[1] 

机构地区：[1]大庆油田总医院心内科,230600

出　　处：《特别健康（下）》2013年第12期415-416,共2页SPECIAL HEALTH

摘　　要：目的：探讨冠状动脉斑块旋磨未治疗前降支球囊难以通过的慢性重度钙化病变的可行性和安全性。方法：回顾性分析了我院2012．1-2012.12完成择期冠脉斑块旋磨术治疗l前降支慢性钙化病变11例，平均年龄67.27±9．59岁，合并糖尿病者2例，合并高血压者8例。造影结果显示11例冠状动脉钙化病变患者的11处钙化病变狭窄程度为70％-100％，病变处接受冠状动脉旋磨术治疗及经皮冠状动脉球囊扩张及支架植入术。着重分析手术方法、手术成功率、术后随访主要心血管事件的发生率。结果：11例患者均成功行冠状动脉旋磨术，术后均植入药物洗脱支架，手术即刻成功率100％。术中均无主要并发症（包括心源性死亡、Q波心肌梗死、心肌穿孔、急诊冠状动脉旁路移植术）发生。所有患者随访9-12个月。有1例再发心绞痛，无心血管事件（包括心源性死亡、心肌梗死：靶病变血运重建）发生。结论：冠状动脉旋磨术联合球囊扩张术和支架植入术治疗前降支钙化病变是安全、有效的方法，可取得很高的手术成功率。Objective To investigate the safety and efficacy of coronary rotational atherectomy in the treatment of anterior descending artery calcification lesions. Methods Retrospective analysis 11 cases involving between January 1,2012 and December 31,2012 diagnosed as anterior descending artery calcification le-sions were treatecl with coronary rotational athereetomy retrospectively. The average age of 67.27±9.59 years old. 2 patients had diabetes ellitus and 8 patients had hypertension, Calcified lesions in the degree of stenosis of 70% to 100%. 11 lesions were treated with rotational atherectomy and PTCA. Procedural success rate and clinical effect of postoperative visitihg ahd main adverse cardiovascular events were recorded and focused on.Results All the burrs passed through the lesions successfully,stents were planted,the immediate success rate was 100%.No main adverse cardiovascular events （including cardiac death,Q wave myocardial infarction,Myocardium perforation and emergency coronary surgery）occurred during operation.Angina was appeared in 1 cases and no major adverse cardiac events （including cardiac death.myocardial infarction and target lesion revascularization）occurred during follow-up for 9-12 months.Conclusion Coronary rotational atherectomy combined with PTCA and stent implantation was effective and safe in the treatment of anterior descending artery calcification lesion.It presented a high procedural suceess rate.

关 键 词：冠状动脉旋磨术 前降支 钙化病变 支架植入术 

分 类 号：R541.4[医药卫生—心血管疾病]