摘要
目的:探讨Guidezilla延长导管在非闭塞性冠状动脉(简称冠脉)钙化病变介入治疗中的有效性和安全性。方法:选择2015年3月至2017年8月收治的非完全闭塞性冠脉钙化病变,由于球囊或支架输送困难,无法通过病变,在Guidezilla导管辅助下实施经皮冠状动脉介入治疗(PCI)的患者。采集人口统计学资料、病史、冠脉病变特征等信息,分析Guidezilla导管操作成功率、介入手术成功率和PCI相关并发症。结果:共选择183例患者,冠脉病变分型为B2/C型者占比99.5%;其中,合并多支血管病变者占94.0%,合并冠脉扭曲或成角者占85.3%。因支架输送失败而使用Guidezilla延长导管者占87.4%。Guidezilla操作成功率和PCI手术成功率分别为89.6%和97.3%。操作相关并发症发生率为3.3%(6例),其中冠状动脉夹层占66.7%(4例),无致死性并发症;住院期间主要心血管不良事件(MACEs)发生率为2.2%(4例);平均12个月的随访期内,MACEs发生率为7.7%(14例)。结论:Guidezilla延长导管能安全有效地用于非闭塞性中重度冠脉钙化狭窄病变的PCI治疗。
Objective:To investigate the efficacy and safety of Guidezilla during percutaneous coronary intervention(PCI)for non-total occlusive calcified coronary lesions.Methods:The patients with non-total occlusive calcified coronary lesions were collected between March 2015 and August 2017.All of them received Guidezilla-assisted PCI due to the difficulties of balloon or stent delivering.The demographic data,medical history,lesion characteristics,Guidezilla procedural success rate,PCI success rate,and PCI-related complications were recorded and analyzed.Results:One hundred and eighty-three patients were selected.Almost all of the coronary calcified lesions(99.5%)were classified as type B2/C.Among which,94.0%were accompanied by multi-vessel diseases and 85.3%coronary tortuosity or angulation.The majority of patients(87.4%)used Guidezilla due to difficulties of delivering stents across the calcified lesions.Guidezilla procedural and PCI success rate was 89.6%and 97.3%,respectively.The incidence of operation-related complications during PCI was 3.3%(6 cases),and among which,66.7%(4 cases)was coronary dissection.The incidence of major adverse cardiac events(MACEs)was 2.2%(4 cases)and 7.7%(14 cases)during hospitalization and the follow-up period of 12-month,respecitively.Conclusions:Guidezilla-assisted PCI is effective and safe in patients with non-total occlusive and moderate-severe calcified coronary lesions.
作者
张书宁
邓欣
姚康
葛雷
钱菊英
葛均波
ZHANG Shu-ning;DENG Xin;YAO Kang;GE Lei;QIAN Ju-ying;GE Jun-bo(Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai Cardiovascular Medical Center,Shanghai Institute of Cardiovascular Diseases,Shanghai 200032,China)
出处
《中国临床医学》
2019年第2期161-165,共5页
Chinese Journal of Clinical Medicine
基金
国家自然科学基金(81570317)
中国中青年临床研究基金-V.G.(2017-CCA-VG-031)~~
