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|本期目录/Table of Contents|

血管内超声指导冠状动脉中重度钙化病变介入治疗的效果

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第4期
页码:
468-471,476
栏目:
临床研究
出版日期:
2014-04-25

文章信息/Info

Title:
Application of intravascular ultrasound in patients with moderate and severe calcified coronary lesions
作者:
王鑫鑫; 杜捷夫; 高 磊; 薛 桥; 田进文; 王 禹
(解放军总医院普通外科，北京100853)
Author(s):
WANG Xin-xin;  DU Jie-fu;  GAO Lei;  XUE Qiao;  TIAN Jin-wen;  WANG Yu
(Department of General Surgery, PLA General Hospital, Beijing 100853, China)
关键词:
血管内超声; 钙化病变; 经皮冠状动脉介入治疗
Keywords:
intravascular ultrasound;  calcified lesions;  percutaneous coronary intervention
分类号:
R541.4;R445.1
DOI:
-
文献标识码:
A
摘要:
目的:评价血管内超声(IVUS)对冠状动脉中-重度钙化病变介入治疗的指导作用及对预后的影响。方法： 2009年1月~2013年1月冠状动脉中-重度钙化病变患者219例接受冠状动脉介入治疗, 其中95例患者术中应用血管内超声指导，124例患者在单纯冠状动脉造影（CAG）指导下完成介入治疗。 结果： 两组患者的临床基线特征、靶血管部位、病变类型、置入支架数目、长度、直径；冠状动脉旋磨和切割球囊应用等方面，差异均无统计学意义。两组患者住院期间及术后30 d临床终点事件，包括主要不良心血管事件（MACE）事件、支架内血栓发生率的差异均无统计学意义。随访12个月时，IVUS组MACE事件发生率显著低于CAG组（8.4% vs. 17.7%,P<0.05），IVUS组靶血管重建发生率显著低于CAG组（3.2% vs. 10.5%,P<0.05）。IVUS组与CAG组在支架内血栓发生率方面差异无统计学意义（3.2% vs. 3.2%）。结论： IVUS指导中-重度冠状动脉钙化病变术后即刻和短期临床效果并不优于CAG，但应用IVUS指导能够显著降低术后1年靶血管重建发生率。
Abstract:
AIM:To assess the value of intravascular ultrasound (IVUS) in moderate or severe calcified coronary artery disease (CAD) and the prognosis. METHODS: Analysis was made in 219 patients with moderate or severe calcified CAD who underwent percutaneous coronary intervention (PCI) from January 2009 to January 2013. Of the 219 patients, 95 patients underwent PCI under the guidance of IVUS and 124 patients under the guidance of conventional coronary angiography (CAG). RESULTS: No statistical difference was observed between groups in clinical baseline characteristics (including target vessel location, lesion type, number of implanted stents, length, diameter, coronary atherectomy and cutting balloon applications) and in clinical endpoints during hospitalization and 30 days after PCI (including MACE events and the incidence of stent thrombosis). The 1-year follow-up found that the MACE event rate and the target vessel revascularization in IVUS group were significantly lower than those in CAG group (8.4% vs. 17.7%; 3.2% vs. 10.5%; both P<0.05). No significant difference was seen in the incidence of stent thrombosis between groups. CONCLUSION: Although IVUS guidance produces no better immediate postoperative and short-term clinical effect in moderate or severe calcified CHD than that of CAG, the application of IVUS guidance can significantly reduce the postoperative 1-year incidence of target vessel revascularization.

参考文献/References

[1]Levine GN, Bates ER,Blankenship JC,et al.2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention:a report of the American college of cardiology foundation/American heart association task force on practice guidelines and the society for cardiovascular angiography and interventions[J].J Am Coll Cardiol,2011,124(23):e574-e651.
[2]Bangalore S,Vlachos HA,Selzer F,et al.Percutaneous coronary intervention of moderate to severe calcified coronary lesions:insights from the National Heart,Lung, and Blood Institute Dynamic Registry[J].Catheter Cardiovasc Interv,2011,77(1):22-28.
[3]Tuzcu EM,Berkalp B,De Franco AC,et al.The dilemma of diagnosing coronary calcification: angiography versus intravascular ultrasound[J].J Am Coll Cardiol,1996,27(4):832-838.
[4]方 哲,周玉杰,刘宇扬,等.血管内超声与光学相干断层扫描在冠状动脉临界病变中的长期随访对比研究[J].心肺血管病杂志,2013,32(3):255-258.
[5]涂超梅,何海武,何淑芬,等.64排螺旋CT对冠心病的诊断价值初探[J].心肺血管病杂志,2011,30(5):424-425.
[6]Scanlon P,Faxon D,Audet A,et al.ACC/AHA guidelines for coronary angiography.A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines(Committee on Coronary Angiography).Developed in collaboration with the Society for Cardiac Angiography and Interventions[J].J Am Coll Cardiol,1999,33(6):1756-1824.
[7]Bashore TM,Bates ER,Berger PB,et al.American College of Cardiology/Society for Cardiac Angiography and Interventions Clinical Expert ConsensusDocument on cardiac catheterization laboratory standards. A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents[J].J Am Coll Cardiol,2001,37(8):2170-2214.
[8]Tanigawa J,Barlis P,Di Mario C.Heavily calcified coronary lesions preclude strut apposition despite high pressure balloon dilatation and rotational atherectomy:in vivo demonstration with optical coherence tomography[J].Circ J,2008,72(1):157-160.
[9]杨丽霞,周玉杰,李月平,等.高龄无保护左主干病变不宜行冠状动脉搭桥患者介入治疗效果评价[J].心肺血管病杂志,2013,32(3):251-254.
[10]Ehara S,Kobayashi Y,Kataoka T,et al.Quantification of coronary calcification by intravascular ultrasound[J].Circ J,2007,71(4):530-535.
[11]Abdel-Wahab M,Richardt G,Joachim Büttner H,et al.High-Speed rotational atherectomy before paclitaxel-eluting stent implantation in complex calcified coronary lesions. the randomized ROTAXUS (rotational atherectomy prior to taxus stent treatment for complex native coronary artery disease) trial[J].J Am Coll Cardiol Intv,2013,6(1):10-19.
[12]吴小凡,吕树铮,陈韵岱,等.冠状动脉闭塞并重度钙化旋磨联合球囊成形和支架植入术一例[J].中华医学杂志,2007,87(15):1072-1074.
[13]Khattab AA,Otto A,Hochadel M,et al.Drug-eluting stents versus bare metal stents following rotational atherectomy for heavily calcified coronary lesions:late angiographic and clinical follow-up results[J].J Interv Cardiol,2007,20(2):100-106.
[14]Maclsaac AI, Baas TA, Buchbinder M, et al. High speed rotational atherectomy: outcome in calcified and non calcified coronary artery lesions［J］. JACC, 1995, 26(3):731-736.

备注/Memo

备注/Memo:
收稿日期：2014-03-27.通讯作者：高磊，副主任医师，主要从事冠心病治疗的基础与临床研究 Email：nkgaolei2010@126.com 作者简介：王鑫鑫，主治医师,博士 Email:301wxx@sina.com
更新日期/Last Update: 2014-05-06