冠状动脉旋磨术联合药物洗脱支架置入术治疗冠状动脉严重钙化病变的临床研究Clinical study of rotational atherectomy combined with drug-eluting stent implantation in the treatment of severe coronary artery calcification lesions
刘健,席晓霞,王伟民,马玉良,李琪,刘传芬,王昭,卢明瑜,赵红
摘要(Abstract):
目的探讨冠状动脉旋磨术联合药物洗脱支架置入术治疗冠状动脉严重钙化病变的安全性和有效性。方法回顾性分析2010年1月1日至2014年12月31日在北京大学人民医院因冠心病行冠状动脉旋磨术和药物洗脱支架置入术的124例患者,共127处病变。对所有患者进行住院期间和出院后随访。分析其手术特点、并发症及主要不良心血管事件(包括心原性死亡、非致死性心肌梗死、介入治疗相关心肌梗死、靶血管再次血运重建)的发生率。结果 124例患者中95例(76.6%)行直接冠状动脉旋磨术,29例(23.4%)行补救性冠状动脉旋磨术,术后均置入药物洗脱支架。手术即刻成功率为100%,使用的旋磨头直径与血管直径比值为(0.50±0.06),每例患者使用的旋磨头数量为1(1,2)个。行血管内超声检查的36例患者使用的旋磨头直径与血管直径比值为(0.52±0.04),每例患者使用的旋磨头数量为1(1,2)个。术中共有19例(15.3%)患者发生并发症,除1例术后12 h因心原性休克死亡外,其余患者处理后均获得良好效果。术后随访15.8(1.7,60.0)个月,主要不良心血管事件的发生率为4.9%(6/122)。结论对冠状动脉严重钙化的患者宜选用冠状动脉旋磨术联合药物洗脱支架置入术治疗,手术即刻成功率高,并发症少。
关键词(KeyWords): 冠状动脉疾病;钙化病变;冠状动脉旋磨术
基金项目(Foundation): 首都卫生发展科研专项项目(首发2014-2-408)
作者(Author): 刘健,席晓霞,王伟民,马玉良,李琪,刘传芬,王昭,卢明瑜,赵红
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