旋磨非标签适应证对冠状动脉斑块旋磨术安全性的影响Effects of application of coronary rotational atherectomy in off-label leisons on clinical outcomes and safety
王涟,宋杰,谢峻,魏钟海,王昆,张静梅,康丽娜,黄为,徐标
摘要(Abstract):
目的评价旋磨非标签适应证对冠状动脉斑块旋磨术(CRA)疗效及安全性的影响。方法连续入选2011年11月至2015年7月在南京鼓楼医院行CRA的患者共94例。非标签适应证包括无保护左主干、严重三支病变、严重左心室功能不全、急性心肌梗死、长病变(>25 mm)及成角病变(≥45°)。具有1个以上非标签适应证的患者为非标签组(75例),无上述特征患者为标签组(19例)。观察两组患者手术成功率和院内主要不良心血管事件(MACE,包括心原性死亡、介入相关心肌梗死和靶血管再次血运重建),多因素回归分析院内MACE的危险因素。结果非标签组慢血流发生率显著高于标签组(20.0%比0,P=0.036),介入相关心肌梗死发生率也显著升高(26.7%比0,P=0.005)。多因素回归分析显示成角病变和靶血管支架总长度与院内MACE呈正相关。结论与标签组相比,非标签组慢血流和介入相关心肌梗死发生率显著升高,而成角病变(≥45°)及置入支架总长度是发生院内MACE的独立危险因素。
关键词(KeyWords): 冠状动脉疾病;钙化病变;斑块旋磨术;危险因素
基金项目(Foundation):
作者(Author): 王涟,宋杰,谢峻,魏钟海,王昆,张静梅,康丽娜,黄为,徐标
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