温尚煜,尚瑞平,于宏颖,王柏颖,孙志奇,王满庆,黎辉

• 1:大庆油田总医院心内科

摘要(Abstract)：

目的分析冠状动脉内旋磨术并发症的发生情况、预防及处理方法。方法分析大庆油田总医院自2000年1月至2016年10月连续248例成功行冠状动脉内旋磨术患者并发症发生情况、预防及处理结果。结果共有27例(10.9%)患者发生旋磨术并发症,其中冠状动脉痉挛2例(0.8%)、慢血流/无复流8例(3.2%)、夹层5例(2.0%)、旋磨头嵌顿6例(2.4%)、导丝断裂3例(1.2%)及冠状动脉穿孔3例(1.2%),所有术中并发症均通过介入治疗成功处理。住院期间共有14例(5.6%)患者发生主要不良心脑血管事件(major adverse cardiac and cerebrovascular events,MACCE),均为介入治疗相关心肌梗死。无心源性死亡、无卒中、无靶病变血运重建发生。结论冠状动脉内旋磨术治疗钙化病变并发症发生率较低,具有同常规介入治疗相似的安全性。

关键词(KeyWords)： 旋磨术;并发症;冠状动脉介入治疗;钙化病变

Abstract:

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基金项目(Foundation):

作者(Author): 温尚煜,尚瑞平,于宏颖,王柏颖,孙志奇,王满庆,黎辉

参考文献(References)：

• [1]Reisman M,Safian RD.The Manual of interventional cardiology.Physicians’s Press,Royal Oak,2001,617-639.
• [2]DC Warth,MB Leon,W O'Neill,et al.Rotational atherectomy multicenter registry:acute results,complications and 6-month angiographic follow-up in 709 patients.J Am Coll Cardiol,1994,24(3):641-648
• [3]Tomey MI,Kini AS,Sharma SK.Current status of rotational atherectomy.J Am Coll Cardiol Intv,2014,7(4):345–353.
• [4]葛均波,王伟民,霍勇.冠状动脉内旋磨术中国专家共识.中国介入心脏病学杂志,2017,25(2):61-66.
• [5]马玉良,王伟民,刘健,等.冠状动脉旋磨标签外使用的安全性.中国循环杂志,2016,31(8):737-741.
• [6]Abdel-Wahab M,Richardt G,Joachim Büttner H,et al.HighSpeed Rotational Atherectomy Before Paclitaxel-Eluting Stent Implantation in Complex Calcified Coronary Lesions The Randomized ROTAXUS(Rotational Atherectomy Prior to Taxus Stent Treatment for Complex Native Coronary Artery Disease)Trial.J Am Coll Cardiol Intv,2013,6(1):10–19.
• [7]Ellis SG,Popma JJ,Buchbinder M,et al.Relation of clinical presentation,stenosis morphology,and operator technique to the procedural results of rotational atherectomy and rotational atherectomy-facilitated angioplasty.Circulation,1994,89(2):882-892.
• [8]Koch K,vom Dahk J,Kleinhans E.Influence of platelet GP receptor antagonist on myocardial hypoperfusion during rotational atherectomy as assessed by myocardial Tc-99 sestamibi scintigraphy.J Am Coll Cardiol,1999,33(4):998-1004.
• [9]高炜,霍勇,洪涛,等.冠状动脉旋磨术在复杂病变介入治疗中的应用.心肺血管病杂志,2001,20(3):131-133.
• [10]Mark AG,Mark JY,Paul ST.A case of an entrapped rotational atherectomy burr.Catheter Cardiovasc Interv.2002,57(1):31-33.
• [11]Eric J Topol.Textbook of interventional cardiology 5th edition.Saunders Elsevier,Philadelphia PA,2008,634-640.
• [12]Watt J,Oldroyd KG.Radial versus femoral approach for highspeed rotational atherectomy.Catheter Cardiovasc Interv,2009,74(4):550-554.
• [13]温尚煜,王柏影,刘亮,等.经桡动脉普通导引导管7F无鞘技术治疗冠状动脉复杂病变.中国介入心脏病学杂志,2014,22(7):445-447.