血管内超声评价StentViz技术在冠状动脉弥漫性长病变中指导支架串联植入的效果  

Effect of Stentviz technique in guiding tandem stent implantation reviewed by intravascular ultrasound in coronary artery diffuse long lesions

作　　者：陆奕杉 彭龙华 刘孝钧[1] 徐晤 段洋 冯辉 李志 梁毅[1] Lu Yishan;Peng Longhua;Liu Xiaojun;Xu Wu;Duan Yang;Feng Hui;Li Zhi;Liang Yi(Department of Cardiovascular Medicine,First People's Hospital of Xuzhou City,Xuzhou 221000,China;不详)

机构地区：[1]徐州市第一人民医院心血管内科,徐州221000 [2]徐州医科大学附属医院心血管内科,徐州221000

出　　处：《中国循证心血管医学杂志》2023年第5期601-604,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的 通过与冠状动脉造影(CAG)比较,应用血管内超声(IVUS)评价StentViz技术在冠状动脉(冠脉)弥漫性长病变支架植入术中的应用价值。方法 纳入2019年11月1日至2020年12月31日于徐州医科大学附属医院经CAG检查证实冠脉弥漫性长病变患者50例为研究对象,随机分为CAG组(n=25)和StentViz组(n=25)。术前使用定量冠脉造影(QCA)对两组CAG相关指标(最小管腔直径、参考血管直径、直径狭窄率)进行测量并比较其差异性;在第1枚支架释放后,CAG组和StentViz组分别在常规CAG和StentViz实时指导下定位串联的支架,由同一位介入医师评估到位满意后,释放支架,选择合适的后扩球囊及压力后扩张支架。术后使用QCA对两组的相关指标(最小支架直径、最大支架直径、平均支架直径)进行测量并比较其差异性;术后两组均行IVUS检查测量串联支架重叠部分的长度、支架的最小、最大直径,比较两组在支架的定位(支架串联重叠部分的长度)及扩张性(支架的扩张指数)的差异性。结果 术前经QCA测量,StentViz组和CAG组在最小管腔直径、参考血管直径、直径狭窄率上均无统计学差异(P>0.05),术后经QCA测量,StentViz组和CAG组在最小支架直径、最大支架直径、平均支架直径上均无统计学差异(P>0.05),术后经IVUS测量,在两组的最小支架直径、最大支架直径和平均直径无统计学差异的前提下(P>0.05),StentViz组的支架偏心指数小于CAG组[(0.16±0.08)vs.(0.22±0.09),P=0.027],StentViz组的支架扩张指数大于CAG组[(0.84±0.08)vs.(0.78±0.09),P=0.027],StentViz组支架扩张优于CAG组。StentViz组串联支架重叠部分长度明显小于CAG组[(1.22±0.32) mm vs.(2.20±0.37) mm,P=0.001]。结论 与常规CAG指导冠脉长病变支架植入相比,StentViz可更加清晰的显示支架影,有效指导支架的定位及扩张。Objective To review the application value of Stentviz technique in stent implantation for coronary artery diffuse long lesions(DLL)by using intravascular ultrasound(IVUS)through compared with coronary angiography(CAG).Methods The patients(n=50)with coronary artery DLL conformed by CAG were chosen from the Affiliated Hospital of Xuzhou Medical University from Nov.1,2019 to Dec.31,2020,and they were randomly divided into CAG group and StentViz group(each n=25).The indexes related to CAG[minimal lumen diameter(MLD),reference vessel diameter(RVD),diameter stenosis rate] were detected and compared by using quantitative coronary angiography(QCA)in 2 groups before percutaneous coronary intervention(PCI).After the first stent released,tandem stents were positioned under the real-time guidance of routine CAG or StentViz in 2 groups.The stents were released and appropriate posterior-dilated balloons and post-pressure dilated stents were selected after the same interventional physician evaluated the stents to be in place.The related indexes(minimum,maximum and average stent diameters)were detected and compared by using QCA in 2 groups after PCI.After PCI,IVUS was performed to detect the length of overlapping part of tandem stent and the minimum and maximum diameters of stents in 2 groups,so as to compare the differences in stent positioning(length of overlapping part of tandem stent)and dilation(dilation index of stent)between 2 groups.Results There were no significant differences in MLD,RVD and diameter stenosis rate between StentViz group and CAG group after QCA detection before PCI(P≥0.05).There were no significant diferences in minimum,maximum and average stent diameters between StentViz group and CAG group after QCA detection after PCI(P>0.05).After IVUS detection,on the premise of minimum,maximum and average stent diameters without significant statistical differences(P>0.05),stent eccentric index was lower[(0.16±0.08)us.(0.22±0.09),P=0.027],and stent dilation index was higher[(0.84±0.08)us.(0.78±0.09),P=0.027]in

关 键 词：经皮冠状动脉介入治疗 StentViz 球囊后扩张 冠状动脉造影 支架串联 

分 类 号：R543.3[医药卫生—心血管疾病]