赵林,王刚,胡春阳,金泽宁,柳景华,王志坚,卢春山,迟云鹏,何东方,赵玉英,郭成军,汝磊生

• 1:首都医科大学附属北京安贞医院心内科
• 2:中国人民解放军联勤保障部队980医院心内科

摘要(Abstract)：

目的比较直接正向夹层再进入技术(ADR)和补救性ADR治疗慢性完全闭塞(CTO)病变的成功率、疗效和安全性。方法 2017年1月至2019年12月连续入选北京安贞医院和中国人民解放军联勤保障部队980医院使用Stingray球囊辅助ADR治疗的CTO患者。根据ADR使用的时机分为直接ADR组和补救性ADR组,比较两组患者的临床资料、病变特点、操作过程、手术成功率及住院期间的主要不良心脑血管事件(MACCE)。结果总计入选243例ADR治疗的CTO病变患者,其中直接ADR组127例,补救性ADR组116例。直接ADR组ADR手术成功率高于补救性ADR组(89.0%比77.6%,P=0.017),直接ADR组手术时间[89(42,190)min比145(72,213)min]、曝光时间[35(22,164)min比76(38,175)min]、导丝通过CTO病变的时间[32(15,153)min比75(34,165)min]明显短于补救性ADR组;辐射剂量[1.6(0.4,6.9)Gy比3.4(0.8,13.9)Gy]、对比剂用量[175(85,535)ml比255(115,760)ml]明显低于补救性ADR组,差异均有统计学意义(均P<0.001)。直接ADR组住院期间MACCE发生率略低于补救性ADR组,但差异无统计学意义(2.4%比5.2%,P=0.428)。结论 Stingray球囊辅助下ADR开通CTO病变安全高效。与补救性ADR比,直接ADR提高了ADR的成功率和手术效率,在适宜ADR介入治疗的CTO病变中,建议使用直接ADR。

关键词(KeyWords)： 慢性完全闭塞;Stingray球囊;正向夹层再进入

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金（81670391）

作者(Author): 赵林,王刚,胡春阳,金泽宁,柳景华,王志坚,卢春山,迟云鹏,何东方,赵玉英,郭成军,汝磊生

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