经皮腔内β-射线放射疗法与切割球囊成形术联合治疗冠状动脉支架内再狭窄Intracoronary beta radiation combined with cutting balloon angioplasty for treatment of in-stent restenosis
樊冰,葛均波,Clemens Von Birgelen,钱菊英,王齐兵,葛雷,陈灏珠,Raimund Erbel
摘要(Abstract)：
目的 旨在研究经皮冠状动脉 (冠脉 )内 β 射线放射疗法 (β 放疗 ,Novoste)与切割球囊成形术 (CBA)联合治疗支架内再狭窄 (ISR)的疗效及其安全性。方法 冠脉内支架置入术后ISR >70 %的病人 2 95例 [男性 2 0 5例 ,女性 90例 ,年龄 (5 9 76± 10 83)岁 ],其中 112例均行CBA联合 β 放疗为 β 放疗组 (n =112 ) ,183例单独采用CBA(89例 )或普通球囊扩张成形术 (94例 )为对照组 (n =183)。弥漫性长病变ISR者β 放疗先照射病变远段 ,再回撤导管照射病变近段。所有病例术前、术后即刻及术后随访期行冠脉造影 ,分析病变长度、最小管腔直径 (MLD)、参照管腔直径 (RLD)和管腔直径狭窄百分比 (DS)。随访靶血管再次成形率 (TVR)和主要不良心血管事件 (MACE)发生率。结果 术前及术后即刻两组病人的冠脉造影结果差异无显著性。随访期 (6 3± 1 6月 ) β 放疗组的MLD大于对照组 ,DS小于对照组 ,P <0 0 5。β 放疗组与对照组的心绞痛、心肌梗死及死亡率相似 ,差异无显著性(心绞痛为 10 %vs17% ,心肌梗死为 1%vs 2 % ,死亡率为 0 %vs2 % ) ,但β 放疗组的TVR和MACE明显低于对照组 (TVR为 5 %vs 16 % ,MACE为 10 %vs 2 5 % ,P <0 0 5 )。β 放疗组 2 8例 (2 6 % ,2 8 10 6 )弥漫性长病变ISR ,回撤 β 放疗导管分
关键词(KeyWords)： 放射疗法;切割球囊;再狭窄
基金项目(Foundation):
作者(Author): 樊冰,葛均波,Clemens Von Birgelen,钱菊英,王齐兵,葛雷,陈灏珠,Raimund Erbel
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