经皮冠状动脉腔内冲击波球囊导管成形术在急性和慢性冠状动脉综合征患者钙化病变介入治疗中的有效性及安全性比较  

Effi cacy and safety of intravascular lithotripsy in interventional treatment of calcifi ed lesions in patients with acute and chronic coronary syndromes

作　　者：李海权 马改改 刘小军 苏丹[1] 吕亚瑞 王新宏[1] 韩振华[1] 邓捷 LI Hai-quan;MA Gai-gai;LIU Xiao-jun;SU Dan;LÜYa-rui;WANG Xin-hong;HAN Zhen-hua;DENG Jie(Department of Cardiology,the Second Affi liated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院心内科,陕西西安710004

出　　处：《中国介入心脏病学杂志》2024年第12期676-682,共7页Chinese Journal of Interventional Cardiology

基　　金：陕西省自然科学基金面上项目(2016JM8059)。

摘　　要：目的评估经皮冠状动脉腔内冲击波球囊导管成形术(IVL)治疗急性冠状动脉综合征(ACS)及慢性冠状动脉综合征(CCS)患者冠状动脉钙化的有效性及安全性。方法回顾性分析2023年2月至2024年6月于西安交通大学第二附属医院心内科接受IVL治疗的冠状动脉钙化患者共47例,其中ACS组22例,CCS组25例。通过比较两组患者基线资料、术中并发症、临床成功率及术后30 d随访患者主要不良心血管事件(MACE),评估IVL治疗ACS及CCS患者冠状动脉钙化的有效性及安全性。结果ACS组支架置入成功21例(21/22;95.5%),CCS组支架置入成功25例(25/25;100.0%),差异无统计学意义(P=0.468);ACS组1例(1/22;4.5%)、CCS组3例(3/25;12.0%)患者术中IVL球囊破裂,ACS组1例(1/22;4.5%)患者IVL钙化斑块修饰后慢血流,两组均无IVL相关血管夹层及靶血管破裂发生,术中并发症发生率比较,差异均无统计学意义(均P>0.05)。随访30 d时发生MACE 3例,两组患者MACE发生率比较差异无统计学意义(9.1%比4.0%,P=0.593)。结论对于ACS及CCS患者,IVL治疗冠状动脉钙化均是有效安全的。Objective To evaluate the efficacy and safety of intravascular lithotripsy(IVL)in the treatment of coronary artery calcification in patients with acute coronary syndrome(ACS)and chronic coronary syndrome(CCS).Methods In a retrospective study,patients with coronary artery calcified lesions who underwent IVL treatment at the Department of Cardiology,Second Affiliated Hospital of Xi’an Jiaotong University between February 2023 and June 2024 were enrolled.Among them,22 patients in ACS group and 25 patients in CCS group.The differences in baseline data,complication,clinical success rate and major cardiovascular adverse events(MACE)in patients followed one month after the procedure were compared between the two groups.Results In the ACS group,21 stent implantations were successful(95.5%success rate),while in the CCS group,25 cases were successful(100.0%success rate),showing 12no statistically significant difference between the two groups(P=0.468).There was one case of intraoperative IVL balloon rupture in the ACS group(1/22;4.5%),while in the CCS group,three cases were observed(3/25;12.0%).Additionally,one case in the ACS group(1/22;4.5%)with slow blood flow after IVL calcification modification.No instances of IVL-related vessel dissection or target vessel rupture occurred between the two groups,and there was no statistically significant difference in intraoperative complications(all P>0.05).There was no significant difference in the MACE(9.1%vs.4.0%,P=0.593)between the two groups for follow up of one month.Conclusions The technique of IVL is a safe and effective treatment option for patients with ACS or CCS who have coronary artery calcification lesions.

关 键 词：冠状动脉钙化 经皮冠状动脉腔内冲击波球囊导管成形术 急性冠状动脉综合征 慢性冠状动脉综合征 

分 类 号：R541[医药卫生—心血管疾病]