冲击波球囊与冠状动脉旋磨在慢性完全闭塞合并重度钙化病变中应用的安全性与有效性分析  

Safety and efficacy of shockwave balloon compared to coronary rotational atherectomy in the treatment of chronic complete occlusion with severe calcification

作　　者：关晓楠[1] 马宁[1] 齐丹[1] 刘文婷[1] 赵华[1] 宗敏[1] 谢博洽 张建军[1] GUAN Xiaonan;MA Ning;QI Dan;LIU Wenting;ZHAO Hua;ZONG Min;XIE Boqia;ZHANG Jianjun(Department of Cardiology,Beijing Chao-yang Hospital,Capital Medical University,Beijing,100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院心内科,北京100043

出　　处：《临床心血管病杂志》2025年第1期34-38,共5页Journal of Clinical Cardiology

摘　　要：目的:探讨冠状动脉冲击波球囊与冠状动脉旋磨在慢性完全闭塞合并重度钙化病变患者中应用的安全性与有效性,为临床决策提供参考。方法:回顾性纳入行冠状动脉介入治疗的慢性完全闭塞合并重度钙化病变患者共88例,其中21例采用冲击波球囊技术(SB组),67例采用冠状动脉旋磨(RA组)。比较两组患者一般情况、冠状动脉病变特点、治疗效果、术中并发症和3个月主要心血管不良事件。采用多因素logistic回归分析主要心血管不良事件的危险因素。结果:两组患者一般临床情况、靶病变位置、病变长度、钙化角度等病变情况差异无统计学意义。两组钙化环断裂、支架成功释放、最终血流TIMI 3级等差异无统计学意义。SB组最大支架直径及获得管腔面积大于RA组(均P<0.05),两组术中并发症差异无统计学意义。PSM后,SB组最大支架直径及获得管腔面积大于RA组(均P<0.05),SB组与RA组3个月主要心血管不良事件差异无统计学意义。多因素logistic分析显示,支架最终残余狭窄>20%(OR=12.167,95%CI:1.447~102.319,P=0.021)和最终血流小于TIMI 3级(OR=24.333,95%CI:2.502~236.658,P=0.006)是主要心血管不良事件的独立危险因素。结论:冲击波球囊与冠状动脉旋磨在慢性完全闭塞病变合并重度钙化中应用的安全性相当,都可成功断裂钙化环,冲击波球囊可获得更大管腔面积。Objective To investigate the safety and efficacy of shockwave balloon therapy and coronary rotational atherectomy for patients with severe calcification in chronic total occlusion,and provide reference for clinical decision-making.Methods A retrospective analysis was conducted on 88 patients with chronic complete occlusion complicated with severe calcification who underwent coronary intervention.Among them,21 patients were treated with shockwave balloon(SB group),while 67 patients received coronary rotational atherectomy(RA group).A comparison was made between the two groups in terms of general characteristics,coronary artery disease features,treatment efficacy,intraoperative complications,and major cardiovascular adverse events within 3 months.Multivariate logistic regression analysis was conducted to identify the risk factors for major cardiovascular adverse events.Results There were no statistically significant differences observed in the general clinical data,target lesion location,lesion length,and calcification angle between the two groups,as well as calcification ring rupture,successful stent deployment,and attainment of final blood flow at TIMI-3 level.The SB group exhibited significantly larger maximum stent diameter and lumen area compared to the RA group(both P<0.05),while no significant variances were noted in intraoperative complications between the two groups.The maximum stent diameter and lumen area in the SB group were greater than those in the RA group after PSM(both P<0.05).There was no statistically significant difference in major cardiovascular adverse events within 3 months between the two groups.Multivariate logistic analysis revealed that residual stent stenosis greater than 20%(OR=12.167,95%CI:1.447-102.319,P=0.021)and final blood flow less than TIMI grade 3(OR=24.333,95%CI:2.502-236.658,P=0.006)were independent risk factors for major cardiovascular adverse events.Conclusion The safety of shockwave balloon therapy and coronary rotational atherectomy in treating chronic complete occlusion w

关 键 词：冲击波球囊 冠状动脉旋磨 慢性完全闭塞病变 

分 类 号：R541.4[医药卫生—心血管疾病]