经皮冠状动脉腔内冲击波球囊导管成形术治疗冠状动脉钙化病变的安全性和有效性研究  

A study of the safety and effi cacy of intravascular lithotripsy in the treatment of coronary artery calcifi cation lesions

作　　者：林立志 尹晓荣 崔璐 申程 王明皓 房芳 杜艳艳[2,3] 孙传峰 曹勇 LIN Li-zhi;YIN Xiao-rong;CUI Lu;SHEN Cheng;WANG Ming-hao;FANG Fang;DU Yan-yan;SUN Chuan-feng;CAO Yong(Clinical Medical College of Jining Medical University,Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases,Department of Cardiology,Coronary Heart Disease Second Ward,Affi liated Hospital of Jining Medical College,Jining 272000,China)

机构地区：[1]济宁医学院临床医学院,山东济宁272000 [2]济宁医学院附属医院心内科冠心病二病区 [3]济宁市心血管病疾病诊疗重点实验室

出　　处：《中国介入心脏病学杂志》2023年第11期855-861,共7页Chinese Journal of Interventional Cardiology

基　　金：济宁市重点研发计划项目(2022YXNS022);主诊医师团队专项临床研究计划项目(ZZTD-2022-002)。

摘　　要：目的评估经皮冠状动脉腔内冲击波球囊导管成形术(即血管内碎石术,IVL)治疗冠状动脉钙化病变的安全性和有效性。方法回顾性分析2023年1月至2023年7月于济宁医学院附属医院在血管内成像技术指导下,使用IVL或切割球囊(CB)治疗冠状动脉钙化病变的患者53例(IVL组18例,CB组35例)。通过比较两组的基线资料、临床成功率,住院期间和手术后1个月随访患者主要不良心血管事件(MACE)和1个月内因心血管事件再入院情况,评估IVL治疗冠状动脉钙化病变的安全性和有效性。结果IVL组和CB组的临床成功率(100.0%比100.0%,P>0.999)相同,病变最小管腔面积[(1.7±0.4)mm^(2)比(1.7±0.5)mm^(2),P=0.628]相似,但病变长度[(28.4±9.6)mm比(20.9±8.6)mm,P=0.008]、残余狭窄[(1.7±1.7)%比(6.9±2.0)%,P=0.049]差异均有统计学意义。手术过程中,均无血栓、血管急性闭塞等急性并发症发生。两组住院期间和随访1个月时均无MACE发生(0比0,P>0.999),CB组有3例患者因心绞痛再入院治疗(0比8.6%,P=0.543),但差异无统计学意义。结论IVL治疗冠状动脉钙化病变是安全、有效的。Objective To evaluate the safety and efficacy of intravascular lithotripsy(IVL)in the treatment of coronary artery calcification lesions.Methods A total of 53 patients who underwent endovascular imaging guided treatment of coronary artery calcified lesions with either IVL or cutting balloon(CB)at the Affiliated Hospital of Jining Medical College from January 2023 to July 2023 were retrospectively analysed(IVL:n=18,CB:n=35)were retrospectively analysed to compare the technique,clinical success rate,major adverse cardiovascular events(MACE)and readmission for cardiovascular events in patients followed during hospitalisation and 1 month after the procedure.Results Clinical success rates were identical in the IVL and CB groups(100.0%vs.100.0%,P>0.999),the minimum lumen area of lesions was similar in the VL and CB groups[(1.7±0.4)mm^(2) vs.(1.7±0.5 mm^(2)),P=0.628].And there was a statistically significant difference in the overall mean lesion length between the IVL and CB groups[(28.4±9.6)mm vs.(20.9±8.6)mm,P=0.008].During the procedure,there were no complications such as aneurysm,thrombus,or emergency vessel closure.There was a statistically significant difference in the overall mean value of residual stenosis between the IVL and CB groups[(1.7±1.7)%vs.(6.9±2.0)%,P=0.049].There were no MACE in either group during hospitalisation or at the one-month follow-up(0 vs.0,P>0.999),and 3 patients in the CB group were readmitted for angina pectoris(0 vs.8.6%,P=0.543),with no significant difference in readmission rates between the two groups.Conclusions The technique of intravascular lithotripsy is safe and effective in the treatment of coronary artery calcification lesions.

关 键 词：血管内碎石术 切割球囊 血管内成像 冠状动脉钙化 

分 类 号：R541[医药卫生—心血管疾病]