摘要
目的观察药物包被球囊(DCB)治疗冠状动脉大血管原位病变的疗效。方法回顾性分析2015年5月至2017年7月郑州大学第一附属医院心内科冠状动脉病变血管>2.8 mm且接受DCB治疗的原位病变患者102例,共104处病变,在术后9个月有82例(80.4%)患者行随访冠状动脉造影检查和冠状动脉造影定量分析。观察终点是随访时冠状动脉造影的晚期管腔丢失和主要心血管不良事件,包括心原性死亡、心肌梗死、靶病变血运重建、靶病变或支架内血栓形成。结果104处病变中98处病变单独置入DCB,6例(5.9%)患者因严重冠状动脉夹层进行了补救性支架治疗。2例(2.0%)患者在住院期间出现急性缺血事件驱动的再次血运重建。术中65.4%(68/104)的病变使用切割球囊,26.0%(27/104)的病变使用了棘突球囊。病变长度为(12.57±3.58)mm,DCB长度为(19.87±4.55)mm,随访时晚期管腔丢失为(0.01±0.52)mm。随访期内,靶病变血运重建率和主要心血管不良事件发生率分别为3.9%(4/102)和3.9%(4/102),无死亡、心肌梗死及靶病变血栓形成。结论提示DCB治疗冠状动脉大血管原位病变安全、有效。
Objective To evaluate the efficacy and safety of drug-coated balloons (DCB) for de novo large coronary vessels.Methods One hundred and two patients were retrospectively enrolled in this study,there were 104 lesions with the reference lumen diameter of target vessel more than 2.8 mm and patients were treated with DCB in de novo lesions during May 2015 and July 2017 in our center.Coronary artery angiography and quantitative coronary angiography were performed in 82 (80.4%) patients at follow up period ((8.1±1.7) months post procedure).The endpoints were late lumen loss (LLL) at follow up,and major adverse cardiac events (MACE) including cardiac death,myocardial infarction (MI),target lesion revascularization (TLR) and stent or target lesion thrombosis at 12 months post procedure.Results Ninety-eight lesions were treated with DCB only,6 (5.9%) bailout drug-eluting stent (DES) were used because of severe coronary dissection,2 patients (2.0%) received revascularization driven by acute ischemic events during hospitalization.Cutting balloons and NSE balloons were used in 65.4%(68/104) and 26.0%(27/104) lesions.The lesion length was (12.57±3.58) mm and the DCB length was (19.87±4.55) mm.The late lumen loss was (0.01±0.52) mm during angiographic follow up.The TLR rate and overall MACE rate was 3.9%(4/102) and 3.9%(4/102) and there was no death,MI and target lesion thrombosis at 12 months follow up.Conclusion DCB treatment for de novo large coronary vessels is effective and safe.
作者
邱竞
韩战营
王玺
卢文杰
潘亮
孙国举
秦小飞
王正斌
刘光辉
王徐乐
邱春光
Qiu Jing;Han Zhanying;Wang Xi;Lu Wenjie;Pan Liang;Sun Guoju;Qin Xiaofei;Wang Zhengbin;Liu Guanghui;Wang Xule;Qiu Chunguang(Department of Cardiology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2019年第6期452-456,共5页
Chinese Journal of Cardiology
