摘要
目的 :评价经皮冠状动脉腔内切割球囊成形术 (PTCBA)结合支架术治疗冠脉分叉处病变的安全性及疗效。方法 :对 89例冠心病患者主支病变应用 PTCBA预扩张后置入支架、分支病变单行 PTCBA而不置入支架 ,观察其冠脉病变特点、手术过程相关因素、手术成功率、并发症和近、中期随访结果。结果 :89例患者中分叉处病变位于前降支 /对角支占 71% ,回旋支 /钝圆支占 2 5 % ,右冠脉 /后降支或后侧支占 4%。对分支血管行 PTCBA后 1例因残余狭窄 >5 0 %而植入支架 ,1例因并发轻度钙化且分支成角较大切割球囊未通过 ,改用常规 PTCA球囊扩张成功。病变 PTCBA成功率达 97.8% ;无院内死亡、急性心肌梗死 (AMI)、急性心包填塞及急诊冠脉搭桥术等严重并发症。对手术成功的 87例术后临床随访 3～ 2 6个月 ,无死亡及 AMI等心脏事件发生。临床心绞痛复发率 17.2 %。复查冠脉造影 (CAG)率 5 6.3 % ,示 49处分叉病变主支支架内再狭窄率 14.3 % ,分支血管再狭窄率 18.4%。结论 :PTCBA结合支架术治疗冠脉分叉处病变是一种安全、有效的介入治疗技术 ,其成功率高、并发症少 ,近。
AIM:To evaluate the safety and efficacy of percutaneous transluminal cutting balloon angioplasty(PTCBA) combined with stenting in patients with coronary bifurcation lesions. METHODS:Eighty nine patients with coronary bifurcation lesions underwent stenting after PTCBA in their main vessles and PTCBA alone in side branches. The coronary lesion features,procedure related factors,success rate,severe complications and the result of follow up were investigated respectively.RESULTS:Of the coronary bifurcation lesions in the 89 patients,71% were located in left anterior descending artery/diagonal branches,25% in circumflex artery/obtuse marginal branches ,and 4% in right coronary artery/posterior descending artery or posterior lateral artery. There were 2 cases with PTCBA manipulation failure in side branch,who received conventional balloon dilation or stenting. The PTCBA success rate was 97.8%,and no in hospital complications such as acute myocardial infarction(AMI),acute pericardial tamponade and emergency CABG occurred. During clinical following up of 3~26 months, no severe cardiac events occurred such as death and AMI. Clinical recurrent angina rate was 17.2%. The repeated coronary angiography rate was 56.3%, and the restenosis rate of coronary angiography was 14.3% in main vessels and 18.4% in side branches. CONCLUSION:Stenting combined PTCBA in coronary bifurcation lesions is safe and effective in coronary interventional therapy with higher success rate,lower complication rate and better immediate and mid term efficacy.
出处
《心脏杂志》
CAS
2003年第1期20-22,共3页
Chinese Heart Journal
关键词
切割球囊
支架术
治疗
冠状动脉分叉处病变
冠状动脉疾病
percutaneous transluminal cutting ballon angioplasty
bifurcation lesions
coronary disease
