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小冠状动脉狭窄性病变的介入治疗(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第6期
页码:
522-524
栏目:
临床研究
出版日期:
2003-11-01

文章信息/Info

Title:
Percutaneous coronary intervention in small coronary arteries
作者:
吕安林; 周景昱; 贾国良; 王海昌; 王小燕; 郭文怡; 栾荣华; 李伟杰
第四军医大学西京医院心脏内科, 陕西 西安 710032
Author(s):
LU An-lin;  ZHOU Jing-yu;  JIA Guo-liang;  WANG Hai-chang;  WANG Xiao-yan;  GUO Wen-yi;  LUAN Rong-hua;  LI Wei-jie
Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710032, China
关键词:
小冠状动脉; 冠状动脉狭窄; 介入
Keywords:
small coronary artery;  stenosis;  intervention
分类号:
R540.46　
DOI:
-
文献标识码:
A
摘要:
目的:探讨小冠状动脉(直径<3mm) 狭窄性病变实施普通球囊、切割球囊或小支架介入治疗的疗效和并发症。方法: 小冠脉狭窄性病变介入治疗(PCI) 患者136(男87,女49)例, 年龄32～85 (54±17) 岁。根据手术方法分为普通球囊组、切割球囊组和小支架组。残余狭窄率<30%且无动脉夹层、撕裂等并发症者为手术成功, 术后6个月复查冠脉造影。结果: 普通球囊组32例, 手术成功26例(81%) , 出现动脉夹层或扩张不满意改支架术6例(24%)。切割球囊组48例, 手术成功43例(90%) , 出现动脉夹层或扩张不满意改支架术3例, 出现造影剂血管外漏2例。支架组56例, 手术成功53例(95%) , 出现造影剂血管外漏2例, 出现心包填塞抢救成功1例。3组均未出现血管急性闭塞。术后6个月, 切割球囊组、小支架组、普通球囊组冠脉造影狭窄率分别为23% (11例)、16% (9例)、38% (12例)。结论: 小冠脉狭窄性病变实施介入治疗能取得显著效果, 小支架术优于普通球囊扩张术, 切割球囊扩张与普通球囊扩张具有近似疗效。
Abstract:
AIM: To assess the clinical and angiographic benefits of traditional percutaneous transluminal coronary angioplasty (PTCA), elective stenting and cutting balloon angioplasty (CBA) in small-diameter coronary arteries (<3 mm). METHODS: We studied 136 patients who were enrolled in the standard balloon angioplasty or intracoronary stenting or cutting balloon angioplasty with lesions located on a small coronary artery. Among them 56 were randomly assigned to receive a stent, 48 to CBA and 32 to PTCA. The primary endpoint of the study was the incidence of restenosis, defined as 50% or greater diameter stenosis at follow-up angiography. RESULTS: Successful procedure was similar in the three groups (95% vs 90% vs 81%, P>0.05). Dissecting or residual stendsis occurred in 6 patients in stent groups and 3 in CBA groups. Contrast medium releasing out of vessels occurred in 2 patients of the PTCA group and the CBA group respective. One patient in stent group w as found to have pericardial temponade. Angiographic restenosis occurred in 16% of the patients who received a stent, in 23% of the CBA patients and in 38% of the PTCA patients. CONCLUSION: Percutaneous coronary intervention in small coronary arteries appears to be safe and associated with satisfactory effect. Compared with traditional PTCA, elective treatment with the stent improves the angiographic outcome, though CBA and traditional PTCA each have their own particular features.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2002-09-03.
更新日期/Last Update: 2003-11-01