葛雷,秦晴,陆浩,吴轶喆,钱菊英,樊冰,王齐兵,颜彦,姚康,马剑英,张峰,黄东,沈雳,王翔飞,葛均波

• 1:复旦大学附属中山医院心内科

摘要(Abstract)：

目的回顾性分析复旦大学附属中山医院心内科行冠状动脉内高频旋磨术患者临床资料,评估冠状动脉内高频旋磨术的安全性及短期、长期预后。方法连续入选复旦大学附属中山医院自2001年2月至2013年9月行冠状动脉内旋磨术的患者共77例,分析术前及术后冠状动脉造影资料,收集临床信息,并通过门诊及电话随访评估其预后。结果手术成功率为93.5%,住院期间不良临床事件发生率为3.9%,其中心肌梗死1例(1.3%),再次介入治疗及外科旁路移植治疗3例(3.9%);1年随访发现,严重不良心脑血管事件发生率(MACCE)为13.0%,其中急性心肌梗死(MI)发生率为1.3%,靶病变血运重建(TLR)率为9.1%,心源性死亡率为3.9%;在中位时间为1 042 d的长期随访中发现,MACCE发生率为18.2%,其中MI为3.9%,TLR为10.4%,心源性死亡率为5.2%,根据Kaplan-Meier估测长期无MACCE生存率为(53.5±14.4)%。将置入裸金属支架(BMS)患者除外后,置入药物洗脱支架(DES)患者1年MACCE为4.8%,其中TLR为1.6%,长期随访MACCE为12.9%,TLR为4.8%。结论冠状动脉内高频旋磨术后置入支架的手术成功率高,其中置入DES患者的短期及长期预后均较好。

关键词(KeyWords)： 高频旋磨;冠状动脉钙化病变;单中心经验

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81300209);; 上海自然科学基金(12ZR1405200)

作者(Author): 葛雷,秦晴,陆浩,吴轶喆,钱菊英,樊冰,王齐兵,颜彦,姚康,马剑英,张峰,黄东,沈雳,王翔飞,葛均波

参考文献(References)：

• [1]Camnitz WM,Keeley EC.Heavily calcified coronary arteries:the bane of an interventionalist's existence.Journal of interventional cardiology,2010,23:254-255.
• [2]HoffmannR,Mintz GS,Popma JJ,et al.Treatment of calcified coronary lesions with Palmaz-Schatz stents.An intravascular ultrasound study.European heart journal,1998,19:1224-1231.
• [3]Moussa I,Di MC,Moses J,et al.Coronary stenting after rotational atherectomy in calcified and complex lesions.Angiographic and clinical follow-up results.Circulation,1997,96:128-136.
• [4]Vaquerizo B,Serra A,Miranda F,et al.Aggressive plaque modifi cation with rotational atherectomy and/or cutting balloon before drug-eluting stent implantation for the treatment of calcifi ed coronary lesions.Journal of interventional cardiology,2010,23:240-248.
• [5]来晏,姚义安,罗裕,等.冠心病患者靶病变钙化特征的研究.中国介入心脏病学杂志,2013,21:341-345.
• [6]Mintz GS,Popma JJ,Pichard AD,et al.Patterns of calcification in coronary artery disease.A statistical analysis of intravascular ultrasound and coronary angiography in 1155 lesions.Circulation,1995,91:1959-1965.
• [7]Rathore S,Matsuo H,Terashima M,et al.Rotational atherectomy for fibro-calcific coronary artery disease in drug eluting stent era:procedural outcomes and angiographic follow-up results.Catheterization and cardiovascular interventions:offi cial journal of the Society for Cardiac Angiography&Interventions,2010,75:919-27.
• [8]Tran T,Brown M,Lasala J.An evidence-based approach to the use of rotational and directional coronary atherectomy in the era of drug-eluting stents:when does it make sense?Catheterization and cardiovascular interventions:offi cial journal of the Society for Cardiac Angiography&Interventions,2008,72:650-662.
• [9]Khattab AA,Richardt G.Rotational atherectomy followed by drug-eluting stent implantation(Rota-DES):a rational approach for complex calcified coronary lesions.Minerva cardioangiologica,2008,56:107-115.
• [10]Jiang J,Sun Y,Xiang MX,et al.Complex coronary lesions and rotational atherectomy:one hospital's experience.Journal of Zhejiang University Science B,2012,13:645-651.
• [11]Dill T,Dietz U,Hamm CW,et al.A randomized comparison of balloon angioplasty versus rotational atherectomy in complex coronary lesions(COBRA study).European heart journal,2000,21:1759-1766.
• [12]Mauri L,Reisman M,Buchbinder M,et al.Comparison of rotational atherectomy with conventional balloon angioplasty in the prevention of restenosis of small coronary arteries:results of the Dilatation vs Ablation Revascularization Trial Targeting Restenosis(DART).American heart journal,2003,145:847-854.
• [13]Garcia DE,Lara J,Pinar E,et al.Percutaneous coronary intervention in heavily calcified lesions using rotational atherectomy and paclitaxel-eluting stents:outcomes at one year.Revista espanola de cardiologia,2010,63:107-110.
• [14]Mezilis N,Dardas P,Ninios V,et al.Rotablation in the drug eluting era:immediate and long-term results from a single center experience.Journal of interventional cardiology,2010,23:249-253.