单中心准分子激光冠状动脉消融术治疗复杂冠状动脉病变的安全性和有效性分析  

Safety and efficacy of single center excimer laser coronary atherectomy in the treatment of complex coronary artery diseases

作　　者：丁澍[1] 李璇[1] 袁伟[1] 孙涛[1] 仲建军 李权[1] DING Shu;LI Xuan;YUAN Wei;SUN Tao;ZHONG Jianjun;LI Quan(The Department of Cardiology,the Affiliated Hospital of Jiangsu University,Zhengjiang,Jiangsu 202001,China)

机构地区：[1]江苏大学附属医院心内科,江苏省镇江市202001

出　　处：《中国动脉硬化杂志》2022年第6期513-516,共4页Chinese Journal of Arteriosclerosis

基　　金：镇江市重点研发计划(社会发展)项目(SH2019072)。

摘　　要：目的探讨准分子激光冠状动脉消融术(ELCA)在复杂冠状动脉病变中的安全性和有效性。方法纳入2018年12月—2021年1月江苏大学附属医院心内科行ELCA辅助介入治疗的复杂冠状动脉病变病例5例共6处病变,观察ELCA成功率、PCI成功率和临床成功率,以及PCI并发症、术后住院期间和6个月随访期主要不良心脏事件(MACE)。结果6处病变均为支架内再狭窄,其中完全闭塞病变3处,严重钙化病变1处,三支病变比例40.0%。ELCA成功率、PCI成功率和临床成功率均为100%,PCI并发症为0。光学相干断层扫描见ELCA处理后局部内膜撕裂(7.00±3.46)处,PCI后相较ELCA处理后无论最小管腔直径(MLD)[(2.56±0.27)mm比(1.47±0.37)mm,P=0.006]还是最小管腔面积(MLA)[(6.48±1.16)mm^(2)比(2.14±0.62)mm^(2),P=0.005]均明显增加。住院期间MACE发生率为0,6个月内发生MACE 3例,其中2例心绞痛,1例心肌梗死,均行靶血管血运重建。结论ELCA辅助治疗复杂冠状动脉病变院内随访安全有效。Aim To investigate the safety and efficacy of excimer laser coronary atherectomy(ELCA)in the treatment of complex coronary artery diseases.Methods From December 2018 to January 2021,5 cases of complex coronary artery lesions treated with ELCA assisted interventional therapy in the Department of Cardiology of the Affiliated Hospital of Jiangsu University were included.The success rate of ELCA,PCI and clinical success rate,PCI complications,major adverse cardiac events(MACE)during postoperative hospitalization and 6-month follow-up were observed.Results All of 6 lesions were in-stent restenosis,including 3 completely occluded lesions and 1 severely calcified lesion.The proportion of three vessel lesions was 40.0%.The success rate of ELCA,PCI and clinical success rate were 100%,and the complication of PCI was 0.Optical coherence tomography showed local intimal tears(7.00±3.46)after ELCA treatment.After PCI,both minimum lumen diameter(MLD)((2.56±0.27)mm vs(1.47±0.37)mm,P=0.006)and minimum lumen area(MLA)((6.48±1.16)mm^(2) vs(2.14±0.62)mm^(2),P=0.005)increased significantly compared with ELCA treatment.The incidence of MACE during hospitalization was 0.Three cases of MACE occurred within 6 months,including 2 cases of angina pectoris and 1 case of myocardial infarction.Conclusion ELCA is safe and effective as an adjuvant treatment for complex coronary artery lesions during hospitalization follow-up.

关 键 词：准分子激光冠状动脉消融术 复杂冠状动脉病变 经皮冠状动脉介入治疗 

分 类 号：R5[医药卫生—内科学]