药物涂层球囊治疗老年冠状动脉分支开口病变病人的疗效观察被引量：1

Effect of drug-coated balloons in patients with Medina 0,0,1 coronary bifurcation lesion

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摘要目的探讨药物涂层球囊(DCB)治疗老年冠状动脉分支开口病变的疗效。方法回顾性分析南京市第一医院2018年1月至2021年6月确诊的81例老年冠状动脉分支开口病变病人,收集并分析其一般临床资料、实验室检查结果、冠状动脉造影定量分析结果以及介入治疗经过及随访结果。结果冠状动脉分支开口病变病人共81例,其中男58例,女23例,平均年龄为(70.1±7.1)岁。临床表现为ST段抬高型心肌梗死9例,非ST段抬高型心肌梗死7例,不稳定型心绞痛55例,稳定型心绞痛10例。81处靶病变中,29例为回旋支开口病变,44例为第一对角支开口病变,4例为钝缘支开口病变,4例为后侧支开口病变。病变长度为(18.98±6.40)mm,DCB长度为(20.38±3.26)mm,即刻管腔获得(1.12±0.32)mm。5例病人DCB后出现C型以上的夹层,均行补救性植入支架。随访期间4例病人行再次靶病变血运重建治疗,其中3例发生在DCB治疗后,1例为补救性支架治疗术后;均未出现死亡及心肌梗死。复查造影显示最小管腔直径和直径狭窄程度较术后即刻差异无统计学意义,晚期管腔丢失(0.02±0.32)mm。结论DCB治疗冠状动脉分支开口病变安全有效,但仍有待于大规模随机对照研究证实。 Objective To evaluate the efficacy and safety of drug-coated balloons(DCB)in the treatment for Medina 0,0,1 coronary bifurcation lesion.Methods A total of 81 consecutive patients with Medina 0,0,1 coronary bifurcation lesion who were admitted to our hospital from January 2018 to June 2021 were enrolled in this study,and the clinical features,treatment and follow-up results were collected and analyzed.Results Among the 81 patients,there were 58 males and 23 females,with a mean age of 70.1±7.1 years old;Nine cases presented with ST-elevation myocardial infarction,7 cases with non ST-elevation myocardial infarction,55 cases with unstable angina and 10 cases with stable angina.Coronary angiography showed that ostial circumflex was involved in 29 cases,ostial diagonal was involved in 44 cases,ostial obtuse marginal was involved in 4 cases,and ostial posterior lateral was involved in 4 cases.The lesion length was 18.98±6.40 mm,the DCB length was 20.38±3.26 mm and the acute lumen gain was 1.12±0.32 mm after procedure.The late lumen loss was 0.02±0.32 mm during angiographic follow-up.Drug-eluting stent(DES)were used in 5 cases because of severe coronary dissection.During the follow-up,4 patients underwent target revascularization,including 3 cases after DCB treatment and 1 case after salvage stent treatment.There were no death and myocardial infarction during the follow-up.Conclusions DCB treatment for Medina 0,0,1 coronary bifurcation lesions is effective and safe,but further studies are still needed to demonstrate the results.

作者郑亚国许田左广锋陈亮林松 ZHENG Ya-guo;XU Tian;ZUO Guang-feng;CHEN Liang;LIN Song(Department of Cardiology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区南京医科大学附属南京医院(南京市第一医院)心内科

出处《实用老年医学》 CAS 2023年第6期599-602,共4页 Practical Geriatrics

基金南京市卫生局重点项目(ZKX16049)。

关键词冠状动脉分支开口病变药物涂层球囊经皮冠状动脉介入治疗 small branch ostial lesions drug-coated balloons percutaneous coronary intervention

分类号 R541.4 [医药卫生—心血管疾病]

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参考文献2

1翟东东,高炬,张萌,刘鸿宇,王斌,曲涛.药物涂层球囊在冠状动脉分支开口病变中的应用[J].中国介入心脏病学杂志,2017,25(7):390-394. 被引量：11
2陈韵岱,王建安,刘斌,季福绥,邱春光,乔树宾.药物涂层球囊临床应用中国专家共识[J].中国介入心脏病学杂志,2016,24(2):61-67. 被引量：205

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