张蒙,陈瑶琳,廖建泉,王尹曼,姚康,葛均波

• 1:复旦大学附属中山医院心内科上海市心血管病研究所
• 2:复旦大学附属中山医院厦门医院心脏内科

摘要(Abstract)：

目的 探讨行冠状动脉内旋磨术（RA）失败患者的临床及病变特征。方法 回顾性分析复旦大学附属中山医院2015年3月至2019年12月558例因冠状动脉严重狭窄合并冠状动脉钙化行RA患者，结果发现14例治疗失败，对其临床资料及病变特点进行分析。结果 14例RA失败患者的平均年龄（69.9±10.3）岁，平均身体质量指数（BMI,22.78±3.17）kg/m2，男10例（10/14），合并高血压病8例（8/14）、糖尿病9例（9/14）、吸烟6例（6/14）；以多支血管病变为主，靶血管左前降支病变10例（10/14）、慢性闭塞病变7例（7/14），病变钙化角度>90o12例（12/14）,RA类型以补救性旋磨为主11例（11/14）；手术失败直接原因包括微导管不能通过旋磨导丝交换失败8例（8/14），旋磨头不能通过病变3例（3/14），术中合并严重并发症而终止手术3例（3/14）。结论 RA治疗失败的直接原因主要为旋磨导丝交换失败、旋磨头通过失败以及术中合并严重并发症，钙化合并严重狭窄、迂曲成角及低BMI可能是旋磨失败的预测因素。

关键词(KeyWords)： 冠状动脉内旋磨术;临床特征;病变特征

Abstract:

Keywords:

基金项目(Foundation): 上海申康临床重点专项基金资助（SHDC2020CR007A）

作者(Author): 张蒙,陈瑶琳,廖建泉,王尹曼,姚康,葛均波

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