摘要
目的:比较腔内影像学技术光学相干断层成像(OCT)与血管内超声(IVUS)指导下冠状动脉斑块旋磨术治疗钙化病变的近期效果。方法:回顾性分析2012年1月至2019年12月于北京大学人民医院行OCT或IVUS指导下旋磨术治疗冠状动脉钙化病变的60例患者(61处病变),根据术中使用OCT或IVUS指导,分为OCT指导组23例(24处病变),IVUS指导组37例(37处病变)。并对两组患者的临床基线特征、病变及手术特点,腔内影像学结果,住院期间主要不良心血管事件进行比较分析。结果:两组患者的临床基线资料比较,差异均无统计学意义(P>0.05)。(1)病变及手术特点方面:两组患者手术即刻成功率均达100%;住院期间无主要不良心血管事件发生;OCT指导组对比剂用量多于IVUS指导组([322.9±106.1)ml vs(.270.6±81.2)ml,P=0.034],差异有统计学意义。(2)腔内影像学结果方面:与IVUS指导组比较,OCT指导组可以获得更高的支架膨胀率[(82±8)%vs(.75±10)%,P=0.002],差异有统计学意义。结论:腔内影像学技术OCT与IVUS对于指导旋磨术治疗冠状动脉钙化病变具有重要作用,OCT比IVUS指导下的旋磨术可以获得更高的支架膨胀率。
Objectives:We aimed to compare the short-term efficacy of optical coherence tomography(OCT)-guided rotational atherectomy(RA)versus intravascular ultrasound(IVUS)-guided RA in the treatment of calcified coronary lesions.Methods:We retrospectively analyzed 60 patients(61 lesions)treated with RA that underwent OCT-guided or IVUSguided from 2012 to 2019 at Peking University People's Hospital.The patients were divided into two groups:OCTguided group(n=23 with 24 lesions)or IVUS-guided group(n=37 with 37 lesions).The baseline clinical features,lesion characteristics,operation data and intravascular imaging findings were compared between the two groups.Results:There was no difference in baseline clinical features between the two groups(P>0.05).The procedural immediately success rate was 100%in both groups and no major adverse cardiovascular events occurred during hospitalization in all patients.Volume of contrast media was significantly larger in OCT-guided group than in IVUS-guided group([322.9±106.1]ml vs.[270.6±81.2]ml,P=0.034).The percentage of stent expansion was significantly larger in the OCTguided RA group than in IVUS-guided group([82±8]%vs.[75±10]%,P=0.002).Conclusions:Both OCT and IVUS play an important role in guiding RA for patients with calcified coronary lesions. OCT-guided RA for calcified coronary lesions results in larger percent stent expansion compared to IVUS-guided RA in thispatient cohort.
作者
滕玮利
李琪
马玉良
曹成富
刘健
赵红
卢明瑜
宋俊贤
王伟民
TENG Weili;LI Qi;MA Yuliang;CAO Chengfu;LIU Jian;ZHAO Hong;LU Mingyu;SONG Junxian;WANG Weimin(Department of Cardiology,Peking University People's Hospital,Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction,Beijing(100044),China)
出处
《中国循环杂志》
CSCD
北大核心
2020年第11期1084-1090,共7页
Chinese Circulation Journal
基金
国家重点研发计划资助(2016YFC1301105)。
关键词
冠状动脉
光学相干断层成像
血管内超声
钙化病变
旋磨术
coronary artery
optical coherence tomography
intravascular ultrasound
calcified lesions
rotational atherectomy
