摘要
目的探讨64排螺旋CT在经桡动脉行冠状动脉复杂病变介入治疗中的价值。方法择期行经桡动脉经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的复杂病变患者146例,随机分为64排螺旋CT指导组(试验组)及非64排螺旋CT指导组(对照组),其中试验组75例102支病变,对照组71例93支病变,比较两组靶血管病变的特征、介入成功率、手术时间、首选导丝通过率、导引钢丝未能通过率、导引钢丝进入假腔的发生率及并发症,并随访6个月内主要心血管事件发生率。结果试验组与对照组介入成功率分别为94.1%(96/102)vs 84.9%(79/93)(P<0.05)。试验组首选导丝通过率和成功率高于对照组,试验组导丝进入假腔发生率和PCI时间少于对照组,分别为85.3%(39/102)vs 65.5%(33/93),13.7%(4/102)vs 25.8%(30/93),(55.9±17.3)分钟vs(72.4±18.6)分钟(P<0.05或<0.01)。结论在64排螺旋CT冠状动脉成像指导下,行经桡动脉途径冠状动脉复杂病变介入治疗,可提高成功率,缩短手术时间,减少并发症。
Objective To evaluate the clinical value of 64 slice spiral CT angiography for transradial coronary intervention（PC1） in patients with severe complex coronary lesions. Methods Totally 146 patients with severe complex coronary lesions,who would underwent PCI, were randomly assigned to treatment group （75 cases with 102 lesions） received 64 slice spiral CT angiography of coronary artery at admission and before discharge, and control group（71 cases with 93 lesions）. Coronary artery lesion characteristics, procedural success rate, mean procedural time, success rate of the first attempt wire,failure rate of guide wire cross lesions, major complications and rate of guide wire into a false lumen between two groups were analyzed. Follow-up was performed 6 months after procedure for recording major adverse cardiac events（MACE）. Results The procedural success rate was 94. 1% （96 of 102） in treatment group compared with 84.9%（79 of 93） in control group （ P 〈0.05）. The success rate and cross lesion rate of first attempt guide wire were significantly higher,and rate of guide wire into a false lumen were obviously lower with a shorter PCI time in treatment group than those in control group（ P 〈0.05 or d0.01） ,which were 85.3%（39 of 102）vs 65.5%（33 of 93） ,13. 7%（4 of 102） vs 25.8%（30 of 93）,（55.9±17.3） min vs （72.4±18.6） min,respectively. Conclusion 64 slice spiral CT angiography can improve the procedural success rate, shorten procedural time and decrease major complications in transradial coronary intervention of complex coronary lesions.
出处
《临床荟萃》
CAS
2013年第6期613-616,共4页
Clinical Focus
