摘要
目的评估一种新的依据血管不同部位管径差异选择适当球囊进行依序扩张的后扩张技术(msM技术)的临床可行性,并比较msM与最终对吻球囊扩张(FKBI)两种后扩张技术对冠状动脉分叉病变治疗疗效的影响。方法选取102例行冠状动脉造影检查证实为分叉病变并行支架置入术的患者,根据选择的后扩张技术分为FKBI组(54例)和msM组(48例)。比较两组患者的临床特征、血管病变特征、介入治疗情况、随访情况,术前即刻、术后即刻和术后随访的冠状动脉造影检查定量分析(QCA)参数,手术前后血管内超声(IVUS)检查情况,以及住院、随访期间的主要心血管不良事件(MACE)和支架内血栓发生率。结果两组间血栓、夹层、钙化、慢性完全闭塞病变(CTO)的病变构成、病变部位和类型构成,以及主支、分支血管病变长度的差异均无统计学意义(P值均>0.05)。msM组行双支架术的患者构成比、分支血管置入支架的患者构成比、球囊最大释放压力和最大直径均显著低于FKBI组(P值均分别<0.01、0.05)。两组间术前即刻主支血管和分支血管的QCA参数,术后即刻主支血管的QCA参数,以及术后随访主支血管和分支血管的QCA参数的差异均无统计学意义(P值均>0.05);FKBI组术后即刻分支血管的参考血管直径(RVD)、最小管腔直径(MLD)、直径狭窄度(DS%)和管径即刻获得等参数均显著优于msM组(P值均分别<0.05、0.01)。FKBI组和msM组的IVUS检查率分别为37.0%(20/54)和29.2%(14/48),两组间主支血管术前最小管腔面积(MLA)和术后最小支架面积(MSA)的差异均无统计学意义(P值均>0.05),msM组的主支血管支架膨胀指数和支架对称指数明显优于FKBI组(P值均分别<0.05、0.01)。两组间住院、随访期间MACE和支架内血栓发生率的差异均无统计学意义(P值均>0.05)。结论 msM技术使主支血管支架近端的对称指数和膨胀指数优于FKBI技术,但其对临床效果的影
Objective To evaluate the safety and efficacy of msM technique （a new post-dilation strategy in which proper balloon is chosen according to the difference of blood vessel diameter） and compare its clinical outcome with final kissing balloon inflation （FKBI） in treating coronary bifurcation lesions. Methods A total of 102 patients who were diagnosed as bifurcation lesions by coronary arteriongraphy and underwent stent implantation were enrolled in this study. FKBI was performed in 54 patients and msM was carried out in 48 patients. Clinical features, characteristics of vascular lesion, results of interventional therapy, parameters of quantitative coronary arteriongraphy （Q CA）, intravascular ultrasonography （IVUS） results and the incidence of major adverse cardiovascular events （MACE） and thrombus in the stent were compared between msM group and FKBI group. Results There were no significant differences in the incidence of thrombus, aneurysm, angiosteosis or chronic total occlusion （CTO）, position of lesions, or the affected blood vessel length between the two groups （all P〉0.05）. The patient＇s percentage of double stent strategy and stent implantation in bundle branches, the maximum releasing pressure and diameter of balloons in the msM group were significantly lower than those in the FKBI group （P〈0.01, 0.05）. There were no significant differences in QCA results （such as angiographic results of main branch or bundle branch immediately before treatment, angiographic results of main branch immediately after treatment, angiographic results of main branch or bundle branch during follow-up） between groups （all P〈 0.05）. Reference vessel diameter （RVD）, minimal lumen diameter （MLD）, diameter stenosis （DS%） and acute lumen gain of side branch in the FKBI group were significantly superior to those in the msM group （P 〈0.05, 0.01 ）. IVUS was performed in 20 patients （37.0%） of FKBI group and 14 patients （29.2%） of msM. There were no significant diff
出处
《上海医学》
CAS
CSCD
北大核心
2015年第11期805-810,共6页
Shanghai Medical Journal
关键词
分叉病变
介入治疗
药物洗脱支架
最终对吻球囊扩张
Coronary bifurcation lesions
Percutaneous coronary intervention
Drug eluting stent
Finalkissing balloon inflation
