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|本期目录/Table of Contents|

Szabo技术在冠脉开口病变介入治疗中的应用

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第5期
页码:
609-612
栏目:
临床研究
出版日期:
2012-10-25

文章信息/Info

Title:
Clinical evaluation of Szabo technique in percutaneous intervention for ostial lesions
作者:
张海涛1; 孙津津1; 黄丛春1; AARON Wong2; 刘朝中1; 田建伟1; 李玉茜1
(1.空军总医院心内科，北京 100142；
2.新加坡国家心脏中心心内科，新加坡 168752)
Author(s):
ZHANG Hai-tao1;  SUN Jin-jin1;  HUANG Cong-chun1;  AARON Wong2;  LIU Chao-zhong1;  TIAN Jian-wei1;  LI Yu-qian1
(1.Department of Cardiology, PLA General Hospital of Air Force, Beijing 100142, China; 2.Department of Cardiology, National Heart Center Singapore, Singapore 168752)
关键词:
冠状动脉疾病; 血管成形术; 经皮冠状动脉; Szabo技术; 开口病变
Keywords:
coronary disease;  angioplasty;  percutaneous coronary;  Szabo technique;  ostial lesion
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:评价Szabo技术在介入处理冠脉开口部位病变中的安全性和可行性。方法： 回顾性分析自2008年10月~2011年10月采用Szabo技术介入干预的16例冠心病患者，经冠脉造影提示病变符合Medina分类010/001分叉病变或者主动脉-开口部位病变。首先预扩张病变，在送入第1根导丝通过开口-分叉病变后，送第2根导丝作为锚定导丝，在体外穿过支架尾端最末网眼送入另一分支远段，支架近端沿第1根导丝送入病变处，由于锚定导丝作用便可成功精确定位于病变开口。所有患者术后跟踪随访3~12月，其中10例于术后半年进行冠脉造影复查。结果： 所有16例患者中，15例成功采用Szabo技术精确定位释放支架，1例因血管局部钙化支架脱载改用常规方法后成功释放支架；所有病变中9 例位于前降支开口，2例位于右冠开口，2例位于回旋支与钝缘支开口，2例位于右冠后降支与左室后侧支开口；术后跟踪随访3~12月均无心绞痛发作及其它心血管不良事件发生。结论： Szabo技术在介入处理冠脉开口部位病变中可以起到精确定位完全覆盖病变的作用，但对于钙化或弯曲病变将会增加支架脱载的风险。
Abstract:
AIM:To evaluate the safety and feasibility of Szabo technique used in treating lesions on the ostium of the coronary artery. METHODS: In a retrospective study, stenting was attempted using the Szabo technique, from October 2008 to October 2011. There were 16 patients (55.6±5.2 years; 87.5% male) corresponding to Medina 010/001 bifurcations or aorto-ostial lesions. After predilatation, the anchor guidewire (2GW) placed in the side branch was threaded through the most proximal stent cell and the stent was advanced into the target lesion until it was stopped at the carina. Stent was initially inflated at 6 atm and deflated, and after removing the 2GW, the delivery was completed at required atmospheres. All patients were followed up 3-12 months after surgery. Ten patients were rechecked by coronary arteriography after 6 months. RESULTS: The procedure was technically successful in 15 (93.8%) patients. In the remaining patient, a stent dislodged during the procedure due to the severely calcified vessel and the vessel was successfully stented using traditional techniques. Of all the lesions, nine were located in the ostium of the left anterior descending coronary arteries, two in the ostium of the right coronary artery, two in the ostium of the bifurcation of the left circumflex obtuse marginal branch, and two in the ostium of the posterior descending artery bifurcating the posterior lateral artery. Angina or other adverse cardiovascular events occurred in none of the 16 patients 3-12 months after procedures. CONCLUSION: Szabo technique can accurately implant a stent in Medina 010/001 bifurcations or in aorto-ostial lesions and thus reduce the incidence of angiographic malpositioning, but this technique runs the risk of stent dislodgement in severely calcified or tortuous lesions.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2012-01-30.
作者简介：张海涛，副主任医师，博士生Email:kjzht@sina.com
更新日期/Last Update: 2012-11-16