何云,宋明宝,吴凤,冯杰,钱德慧

• 1:重庆康华众联心血管病医院心血管内科
• 2:重庆南川宏仁医院心血管内科
• 3:四川邻水县人民医院心内科
• 4:陆军军医大学第二附属医院心血管内科

摘要(Abstract)：

目的评估伴行球囊技术(BBT)在经皮冠状动脉介入治疗(PCI)中支架精确定位的安全性和疗效。方法总结分析2014年5月至2019年7月陆军军医大学第二附属医院和重庆康华众联心血管病医院使用BBT的PCI患者资料。所有患者在PCI术中支架随心动周期出现前后明显串动现象,术中应用BBT限制支架串动而实现精确定位。结果共61例患者在PCI中应用了BBT,59例患者应用BBT成功,成功率为96.72%,未发生球囊和导丝嵌顿、夹层、慢血流等并发症。其中57例(93.44%)患者使用预扩张球囊作为伴行球囊,37例(60.66%)患者增加了计划外导丝数量(用于导引伴行球囊),49例(80.33%)增加了计划外压力泵(用于加压伴行球囊)。2例(3.28%)患者应用BBT失败,其中1例发生在右冠状动脉,因导丝缠绕,伴行球囊无法送至支架近端,支架串动无明显改善,改用漂浮导丝技术成功完成手术;另1例发生在左前降支开口,因体位暴露不充分,支架覆盖部分主干,左回旋支开口受影响,改双支架策略。13例(21.31%)患者应用了血管内超声检查,没有支架变形和纵向压缩,支架贴壁和膨胀性良好。12例(19.67%)患者采用了近端优化技术。平均随访15.4个月,随访率100%,未发生不良心血管事件(心原性死亡、靶病变血运重建和心肌梗死)。结论 BBT是PCI术中一种简单安全、成功率高的支架精确定位技术,值得在临床进一步研究和应用。

关键词(KeyWords)： 冠状动脉;伴行球囊技术;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation): 重庆市科卫联合科研项目（QNXM20181720）;; 重庆康华众联心血管病医院院级临床课题（CQKHZL2019010）

作者(Author): 何云,宋明宝,吴凤,冯杰,钱德慧

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