摘要
目的 分析药物洗脱球囊(DCB)治疗冠状动脉(冠脉)极小血管原位病变的安全性及有效性。方法 连续前瞻性入选2019年11月至2020年5月于北京安贞医院等六家医院心内科收入的冠脉病变血管<2.0 mm且接受DCB治疗的原位病变患者29例,在术后9个月有18例(56.25%)患者行随访冠脉造影检查和定量分析。观察入组患者DCB治疗前后血管腔变化并记录不良事件发生率。观察终点是随访时冠脉造影的晚期管腔丢失(LLL)和主要不良心血管事件(MACE),包括靶病变血运重建、死亡、心肌梗死及复合终点。结果 纳入病例靶病变参考血管平均直径为(1.71±0.27) mm,靶病变术前最小管腔直径(MLD)为(0.31±0.24) mm,靶病变LLL平均为(0.13±0.28) mm,术后即刻MLD(1.19±0.20) mm及术后9个月靶血管MLD (1.06±0.31) mm均明显大于术前(P<0.05)。1例患者(5.56%)进行了再次血运重建,DCB处理后随访期间,无心梗或死亡发生。结论 DCB治疗冠脉极小血管原位病变有效、安全。
Objective To analyze the safety and efficacy of drug-coated balloons(DCB)in treatment of de novo coronary lesions in coronary minimal vessels.Methods The patients with de novo coronary lesions and coronary lesion vessel diameter<2.0 mm undergone DCB(n=29)were chosen continuously and prospectively from 6 hospital in Beijing including Beijing Anzhen Hospital from Nov.2019 to May 2020.After DCB for 9 months,there were 18 patients(56.25%)received follow-up coronary angiography(CAG)examination and quantitative analysis.The changes of vascular lumen were observed and the incidence rates of adverse events were recorded before and after DCB.The observation endpoints were late lumen loss(LLL)and major adverse cardiovascular events(MACE)including target lesion revascularization(TLR),death,myocardial infarction and composite endpoint events during follow up period.Results The main diameter of target lesion reference vessels was(1.71±0.27)mm,preoperative target lesion minimal lumen diameter(MLD)was(0.31±0.24)mm,and target lesion LLL mainly was(0.13±0.28)mm.The postoperative immediate MLD was(1.19±0.20)mm and MLD of target vessel was(1.06±0.31)mm 9 months afer the operation,which all were higher than before the operation(P<0.05).The re-revascularization was observed in 1 patient(5.56%).There were no patients with myocardial infarction or died during follow-up period after DCB.Conclusion DCB is effective and safe in treatment of de novo coronary lesions in coronary minimal vessels.
作者
张明多
周渊
张闽
宋现涛
乔树宾
王乐丰
佟倩
张立
石蓓
Zhang Mingduo;Zhou Yuan;Zhang Min;Song Xiantao;Qiao Shubin;Wang Lefeng;Tong Qian;Zhang Li;Shi Bei(Department of Cardiovascular Medicine,Bejing Anzhen Hospital,Capital Medical University,Bejing 100029,China;不详)
出处
《中国循证心血管医学杂志》
2023年第5期587-591,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
心血管疾病精准医学北京实验室项目(PXM2018_014226_000013)。
关键词
药物洗脱球囊
经皮冠状动脉介入治疗
小血管病变
冠状动脉疾病
Drug-coated balloons
Percutaneous coronary intervention
Small vessel lesions
Coronary artery disease
