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联合应用切割球囊与放射治疗对冠脉支架内再狭窄的作用(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第4期
页码:
344-346,349
栏目:
介入治疗
出版日期:
2003-07-01

文章信息/Info

Title:
The effect of cutting balloon combined brachytherapy after coronary angioplasty on in-stent restenosis
作者:
陆士娟1; SengjueTahk2
1.海口市心血管病研究所,海口市人民医院心内科,海南 海口 570208; 2.韩国亚洲大学医院心脏中心
Author(s):
LU Shi-juan1;  Sengjue Tahk2
Haikou Institute of Cardiovascular Diseases, Department of Cardiology of the Municipal People's Hospital of Haikou, Haikou Hainan 570208, China
关键词:
冠状动脉疾病; 支架内再狭窄; 切割球囊; 近距离放射治疗
Keywords:
coronary disease;  in-stent restenosis;  cutting balloon;  brachytherapy
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:探讨联合应用切割球囊及β射线(166Ho)冠脉内放射治疗对支架内再狭窄的作用。方法:对2001-01～2002-03韩国亚洲大学医院心脏中心完成的60例支架内再狭窄的患者,全部使用切割球囊预扩张,满意扩张后使用充满液态166Ho的长球囊(30～40mm)进行冠脉内放射治疗。术后随访主要临床不良事件,并于术后8个月行冠状动脉造影,用MEDCONViewer软件包进行定量冠状动脉造影(QCA)分析。结果:60例患者65处支架内再狭窄病变均被满意扩张,血管内放射治疗全部成功,无撕裂、血栓形成等并发症。随访8个月,无1例死亡。5例(8.3%)于术后3个月出现心绞痛行靶病变血管重建术,其余55例患者均于术后8个月行冠状动脉造影,4例于支架内发生再狭窄(7.3%),6例于支架边缘发生再狭窄(10.9%),全部患者无晚期血栓形成、假性动脉瘤及冠状动脉瘤发生。病变长度为25.1±4.7mm。晚期管腔丧失为0.19±0.68mm。最小管腔直径术前为0.38±0.26mm,术后即刻为2.08±0.36mm,8个月随访时为1.82±0.76mm。结论:联合应用切割球囊及β射线(166Ho)冠脉内放射治疗对支架内再狭窄是有效及安全的,可在临床推广应用。
Abstract:
AIM: To evaluate the effect of intracoronary brachytherapy using 166Ho after cutting balloon angioplasty on in-stent restenosis. METHODS: The total 65 lesions of 60 patients with in-stent restnosis in Cardiovascular Center of Ajou University Hospital Koren from January 2001 to March 2002 were treated using long balloon which was filled with 166Ho solution after cutting balloon angioplasty. Follow-up angiography and quantitative coronary angiography (QCA) were performed after 8 months of the therapy, in which the QCA was performed by MEDCON Viewer QCA softwar epackage. RESULTS: The procedures were successful in all 60 patients (100%). No complications occurred. Target vessel revascularizations were done in 5 cases (8.3%) during 3 months of post-procedure. Follow-up angiographies were performed in 55 cases after 8 months, among whom binary(?) restenosis in stent segments were discovered in 4 cases (7.3%) and those in edge segment in 6 cases (10.9%).The minimum luminal diameter was 0.38±0.26mm before angioplasty, 2.08±0.36mm immediately after angioplasty and 1.82±0.76mm at 8 months' follow-up. The lesion length was 25.1±4.7mm. No coronary aneurysm and pseudoaneurysm were complicated. CONCLUSION: The brachytherapy using 166 Ho after cutting balloon angioplasty on in-sten trestenosis maybe safe and feasible.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2003-03-18.
更新日期/Last Update: 2003-07-01