陈联胜,孙明明,梁稳生,梁富,唐宇霖,黄美萍,谢年谨,黄育铭

• 1:南方医科大学附属广东省人民医院(广东省医学科学院)广东省人民医院心导管室
• 2:南方医科大学附属广东省人民医院(广东省医学科学院)广东省人民医院心内四区

摘要(Abstract)：

目的 评估准分子激光冠状动脉斑块消蚀术（ELCA）辅助治疗冠状动脉慢性完全闭塞（CTO）病变的安全性和有效性。方法 回顾性分析2021年7月至2023年8月广东省人民医院139例ELCA患者中筛选的29例CTO病变，收集基线及手术资料、并发症及中位随访16.5个月的主要不良心脑血管事件（MACCE）。结果 29例患者平均年龄（65.9±9.4）岁，51.7%存在中重度钙化，58.6%日本多中心CTO注册研究（J-CTO）评分≥2分。总体手术成功率89.7%。22例因器械无法通过启用ELCA的患者中：单纯ELCA器械通过率72.7%(16/22)；剩余6例中5例联合旋磨术后器械通过率100%(5/5)。62.1%(18/29)使用较小的（0.9 mm）激光导管。术中14例（48.3%）应用血管内超声。围手术期并发症：3例手术失败（1例入路相关腹膜后血肿死亡；1例器械未通过放弃；1例术前基础疾病导致术后死亡），2例（6.9%）出现急性无复流，处理后血流恢复至心肌梗死溶栓治疗试验（TIMI）血流分级Ⅲ级。23例（79.3%）置入支架，5例（17.2%）仅行经皮冠状动脉腔内成形术。中位随访16.5(12.8,25.3)个月（失访1例），MACCE发生率20.0%(5/25)：靶血管再闭塞2例（分别发生于术后1、3个月）；脑卒中3例（发生于术后13、15、25个月）。结论 ELCA是处理经皮冠状动脉介入治疗CTO病变中器械障碍的有效辅助手段，手术成功率高，并发症可控。

关键词(KeyWords)： 经皮冠状动脉介入治疗;慢性完全闭塞;准分子激光冠状动脉斑块消蚀术;钙化病变;有效性;安全性

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈联胜,孙明明,梁稳生,梁富,唐宇霖,黄美萍,谢年谨,黄育铭

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