摘要
目的:探讨应用切割球囊预扩张后置入金属裸支架治疗冠状动脉开口病变的远期临床疗效。方法:对66例有冠状动脉开口病变的患者行切割球囊预扩张后置入金属裸支架,并对上述患者进行了6～8个月的冠状动脉造影随访和4年的临床随访。66例中冠状动脉主干开口病变9例,前降支开口病变50例,回旋支和右冠脉动脉开口病变各为3例和4例。按照切割球囊与血管直径1:1的原则,选择切割球囊的大小。结果:66例患者中完成经皮冠状动脉介入治疗(PCI)术后6～8个月冠状动脉造影随访者38例,造影随访率为57.6%,其中9例发生支架内再狭窄。66例中完成4年临床随访55例,其中死亡2例,1例于冠状动脉旁路移植(CABG)术后死亡,1例死于肺癌,发生非 Q 波心肌梗死2例,均由支架内严重再狭窄所致,经再次 PCI 治疗成功。4年间行血管重建术8例,其中再次 PCI 4例,行 CABG 4例,总计心脏事件发生率为16.4%(9/55)。结论:本研究显示切割球囊预扩张后置入金属裸支架有良好的近远期效果,未发现有晚期血栓形成致心脏事件的证据。
Objective：To evaluate the long-term outcomes of cutting balloon（CB） predilatation followed by bare metal stenting for treatment of coronary artery ostial lesions. Method：Sixty-six patients with coronary artery ostial lesions were treated by CB angioplasty and then stenting. Of the 66 patients,left main coronary artery ostial lesion in 9 patients, left anterior descending artery ostial lesion in 50 patients, circumflex coronary artery ostial and right coronary artery ostial lesions in 3 and 4 patients respectively. We selected the sizes of CB for predilatation with vessel diameter to CB ratio fo 1： 1. Result ：The procedural success rate for cutting balloon agioplasty followed by stenting was 100%. The in-stentt restenosis rate at 6-8 month follow-up was 23.7%. Four-year follow-up was completed in 55 patients. Two patients died during the follow-up period. One patient died after CABG operation, the other one died of lung cancer. Two patients had non-Q-wave myocardial infarction due to in-stent restenosis at 7 and 49 months after PCI procedure. Revascularization was performed in 8 patients including CABG in 4 and re-PCI in other 4. Major adverse cardiac events （ including death, myocardial infarction, revascularization） rate at 4-year follow up was 16.4% （9/55）. Conclusion ： This study indicates that use of CB predilation followed by bare metal stenting for treatment of coronary artery os- tial lesions had very good short-and long-term outcomes. No late thrombosis was found during 4-year follow-up. It is an effective method for patients who are intorlerant of long-term double antiplatelet agents after PCI.
出处
《中国循环杂志》
CSCD
北大核心
2007年第6期408-410,共3页
Chinese Circulation Journal
关键词
冠状动脉开口病变
切割球囊
金属裸支架
Coronary artery ostial lesions
Cutting balloon
Bare metal stent
