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|本期目录/Table of Contents|

经桡动脉途径行改良球囊挤压支架术治疗冠状动脉分叉病变

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2009年第2期
页码:
239
栏目:
临床研究
出版日期:
2009-03-30

文章信息/Info

Title:
Effect of modified balloon crushing technique in treatment of coronary bifurcation lesions by transradial access
作者:
周鹏1; 2; 李志樑2; 刘映峰2; 严全能2; 付强2; 肖华2; 陈文忠2
1.成都医学院第一附属医院心内科,四川 成都 610500;2.南方医科大学附属珠江医院心内科，广东 广州 510280
Author(s):
ZHOU Peng1; 2;  LI Zhi-liang2;  LIU Ying-feng2;  YAN Quan-neng2;  FU Qiang2;  XIAO Hua2;  CHEN Wen-zhong2
1.Department of Cardiology, First Affiliated Hospital, Chengdu Medical College, Chengdu 610500, Sichuan, China; 2.Department of Cardiology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, China
关键词:
桡动脉; 分叉病变; 改良球囊挤压支架术; 对吻球囊扩张
Keywords:
Radial;  bifurcation;  modified balloon crushing technique;  kissing balloon inflation
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 分析经桡动脉途径应用改良球囊挤压支架术治疗冠状动脉分叉病变的可行性及成功率。方法 经桡动脉途径造影证实血管病变处有直径>2.5 mm分支,分支起始部有>70%狭窄的患者17例,应用改良球囊挤压支架术治疗分叉病变，观察病变血管狭窄程度、斑块移位及球囊对吻扩张成功率和随访效果。结果 分叉病变中均成功植入雷帕霉素药物洗脱支架,15例患者行同步对吻球囊技术进行后扩张, 术后前向血流均为TIMI Ⅲ级，所有患者未发生边支急性闭塞、支架内血栓、心源性休克、死亡等并发症。结论 冠心病分叉病变介入治疗中，经桡动脉途径通过6F或7F指引管完成改良球囊挤压支架术可获得满意结果,支架间隙小或无，再狭窄率低。
Abstract:
AIM To analyze the feasibility and success rate of modified balloon crushing technique with transradial access in patients with bifurcation lesions. METHODS Seventeen cases of patients with coronary angiography/transradial approach confirmed bifurcation lesions （branch diameter>2.5 mm and the degree of bifurcation stenosis>70%） were enrolled in the study. Bifurcation lesions were treated with modified balloon crushing with transradial access. RESULTS Rapamycin stents were successfully implanted in all bifurcation lesions and final kissing balloon inflation was performed in 15 bifurcated lesions. Angiography showed that the blood flow was TIMI Ⅲ and no serious complications such as acute side-branch occlusion, stent thrombosis, cardiogenic shock or death happened after the modified balloon crushing. CONCLUSION Modified balloon crushing technique can be performed safely with low rate of restenosis. Good results can be achieved if final kissing balloon inflation is performed.

参考文献/References

[1］ Cervinka P, Stasek J, Pleskot M, et al. Treatment of bifurcation lesions by stent implantation only in one parent vessel and angioplasty in side branch: immediate and long term outcome［J］. Invas Cardiol, 2002, 14(4):735-740.

［2］ Iakovou I, Ge L, Colombo A. Contemporary stent treatment of coronary bifurcations［J］. J Am Coll Cardiol, 2005, 46（8）:1446-1455.

［3］ Lefevre T, Morice MC, Sengottuvel G, et al. Influence of technical strategies on the outcome of coronary bifurcation stenting［J］. Eurointervention, 2005, 1（1）:31-37.

［4］ Assail A, Assa HV, Ben-Dor I, et al. Drug-eluting stents in bifurcation lesions: To stent one branch or both?［J］. Catheter Cardiovasc Interv, 2006, 68(6)：891-896.

［5］ Colombo A, Stankovic G, Orlic D, et al. Modified T stenting technique with crushing for bifurcation lesions: immediate results and 30 day outcome［J］. Catheter Cardiovasc Interv, 2003, 60(2)：145-151.

［6］ Lim PO, Dzavik V. Balloon crush: treatment of bifurcation lesions using the crush stenting technique as adapted for transradial approach of percutaneous coronary intervention［J］. Catheter Cardiovasc Interv, 2004, 63(4)：412-416.

［7］ 贾三庆，郭春艳，滕一星,等. 成人右侧桡动脉舒张期最大内径分布调查［J］. 中国介入心脏病学杂志， 2004， 12 (3):162.

［8］ Chen SL, Ye F, Zhang JJ, et al. ［DK crush technique： modified treatment of bifurcation lesions in coronary artery］［J］. Chin Med J(Engl), 2005, 118(20):1746-1750.

备注/Memo

备注/Memo:
收稿日期：2007-7-11.基金项目：广东省科技计划项目资金资助（2004B30601014） 通讯作者：李志樑，教授，主要从事冠状动脉介入治疗和冠心病的免疫机制研究Email：Liz06@163.com 作者简介：周鹏,硕士Email：zhoupeng707707@sohu.com
更新日期/Last Update: 2009-04-16