经皮冠状动脉介入术中双导丝球囊与普通球囊预扩张分支血管治疗冠状动脉分叉病变的安全性和有效性对比分析  

Predilation of branch vessels with dual wire balloon or conventional balloon during percutaneous coronary intervention in treating bifurcation lesions of coronary artery： comparison analysis of safety and efficacy

作　　者：熊然[1] 刘文娴[1] 陈立颖[1] 宁尚秋[1] 康铁朵[1] 李江[1] 盛瑾[1] 黄觊[2] 

机构地区：[1]首都医科大学附属北京安贞医院心脏内科监护室,100029 [2]首都医科大学附属北京安贞医院心内科十五病房,100029

出　　处：《中国医药》2015年第9期1249-1252,共4页China Medicine

基　　金：国家自然科学基金（81000130）

摘　　要：目的 对比冠状动脉介入简单策略治疗冠状动脉分叉病变过程中,应用双导丝球囊与普通球囊预扩张分支血管的有效性及安全性,为分叉病变治疗策略提供依据.方法 回顾性分析201 1年1月至2014年1月首都医科大学附属北京安贞医院心内科经冠状动脉造影证实为冠状动脉分叉病变的患者162例,共170个分叉病变.按照分支血管处理措施分为双导丝球囊组（DB组,78例）和普通球囊组（PB组,84例）,分别给予双导丝球囊和普通球囊预扩张.观察2组患者手术成功率、分支受累情况、并发症及随访主要不良心脏事件（MACEs）发生情况.结果 2组患者临床基线资料与分叉病变受累情况及病变分型比较,差异均无统计学意义（P＞0.05）.2组患者主支血管经皮冠状动脉介入治疗成功率比较,差异无统计学意义（P＞0.05）,但DB组患者分支血管经皮冠状动脉血管成形术成功率高于PB组[94.0％（79/84）比81.4％ （70/86）],差异有统计学意义（P＜0.05）.DB组患者围术期心肌梗死发生率低于PB组[5.1％ （4/78）比17.9％ （15/84）],差异有统计学意义（P＜0.05）.术后随访12个月结果表明,DB组MACEs发生率低于PB组患者[6.7％（5/75）比15.0％ （12/80）],差异有统计学意义（P＜0.05）.结论 冠状动脉介入简单策略治疗冠状动脉分叉病变过程中,应用双导丝球囊行预扩张对比普通球囊安全、有效,成功率较高,并发症较少,是临床实践中治疗冠状动脉分叉病变安全、有效、可行的方法.Objective To evaluate the safety and efficacy of predilation of branch vessels with dual wire balloon or conventional balloon during percutaneous coronary intervention （PCI） with simple strategy in treating bifurcation lesions of coronary artery.Methods Totally 162 patients with 170 bifurcation lesions of coronary artery confirmed by coronary angiography who underwent PCI with simple strategy from Janunary 2011 to Janunary 2014 retrospectively analyzed.During PCI,the branch vessels were predilated with dual wire balloon （DB group,78 cases） or conventional balloon （PB group,84 cases）.The procedural success rate of PCI and percutaneous transluminal coronary angioplasty （PTCA）,involvement of branch vessel,complications and incidence of major adverse cardiac events （MACEs） were compared between the two groups.Results The clinic characteristics,site and Duke classification of bifurcation were not significantly different between the two groups （P 〉 0.05）.The procedural success of PCI for the main vessels was 100% （84/84） in DB group and 97.7% （84/86） in PB group,without significant difference （P 〉 0.05）,but the procedural success rate of PTCA for branch vessels in DB group was significantly higher than that PB group [94.0% （79/84） vs 81.4% （70/86）] （P 〈 0.05）.The incidence of perioperative myocardial infarction in DB group was significantly lower than that in PB group [5.1% （4/78） vs 17.9% （15/84）] （P 〈 0.05）.During 12-months of follow-up,the incidence of MACEs in DB group was significantly lower than that in PB group [6.7% （5/75） vs 15.0% （12/80）] （P〈0.05）.Conclusion During PCI with simple strategy in treating bifurcation lesions of coronary artery,it is safe and effective to pre-dilate the branch vessels with dual wire balloon,with higher success rate and less complications compared with conventional balloon.

关 键 词：经皮冠状动脉介入 双导丝球囊 分叉病变 简单策略 

分 类 号：R541.4[医药卫生—心血管疾病]