药物涂层球囊在前降支开口病变中应用的有效性及安全性研究

Efficacy and safety of drug coated balloon in treatment of ostial lesion of left anterior descending branch

目的探讨药物涂层球囊(Drug Coated Balloon,DCB)在前降支开口病变中应用的有效性及安全性。方法回顾性收集2018年1月—2019年12月在华中阜外医院明确诊断为前降支开口病变并接受药物涂层球囊或药物洗脱支架介入治疗及有效随访的72例患者,随访10个月并复查冠脉造影,分析患者临床基线资料、术前与术后的造影结果及随访结果。结果72例患者均无心肌梗死、卒中、猝死、靶血管再血管化及靶病变再血管化治疗的。支架组术后即刻MLD(Minimum Lumen Diameter,MLD)和QFR(Quantitative Flow Ratio,QFR)均要优于药物涂层球囊,差异有统计学意义[(3.24±0.28)mm vs(2.83±0.38)mm P<0.05;(0.91±0.03)mm vs(0.88±0.04)mm P<0.05]。10个月复查时,支架组QFR较术后即刻下降,差异有统计学意义(0.91±0.03 vs 0.87±0.12;P=0.047),MLD较术后即刻有下降趋势,差异无统计学意义[(3.24±0.28)mm vs(3.14±0.54)mm;P=0.268];药物球囊组QFR相比较于支架组随着时间变化,总体趋势在改善,而MLD在两组间的变化趋势无统计学意义(P>0.05)。结论药物涂层球囊在前降支开口病变中的应用有效、安全。

Objective To explore the effectiveness and safety of drug-coated balloons in the treatment of ostial lesions of anterior descending branch.Methods A retrospective collection of 72 patients who were clearly diagnosed as ostial lesion of left anterior descending branch in Fuwai Huazhong Cardiovascular Hospital from Jan 2018 to Dec.2019 and received interventional treatment with drug-coated balloon or drug-eluting stent and follow-up in 10 months effectively.ALL The patients were implemented coronary angiography.The patient’s clinical baseline data,preoperative and postoperative angiographic results and follow-up results were analyzed.Results None of the 72 patients had recurrence of recurrence of myocardial infarction,stroke,sudden death,target vessel revascularization and target lesion revascularization treatment.Both Minimum Lumen Diameter(MLD)and Quantitative Flow Ratio(QFR)immediately after operation in the stent group were better than drug-coated balloon group,and the difference was statistically significant[(3.24±0.28)mm vs(2.83±0.38)mm P<0.05;(0.91±0.03)mm vs(0.88±0.04)mm,P<0.05].In the stent group,the QFR of was lower than that immediately after the operation,and the difference was statistically significant[(0.91±0.03)vs(0.87±0.12);P=0.047],The MLD had a downward trend compared with that after the operation,and the difference was not statistically significant(3.24±0.28)mmvs(3.14±0.54);P=0.268 in the 10-month’s later.Compared with the stent group,the overall trend of QFR in the drug balloon group was improved over time,while the change trend of MLD between the two groups was not statistically significant.Conclusion The application of drug coated balloon in ostial of left anterior descending branch is effective and safe.