摘要
目的采用血管腔内超声(IVUS)观察SAFE-CUTTM球囊成形术(SFCT)治疗冠状动脉(冠脉)狭窄的安全性和疗效。方法冠脉狭窄>70%的冠心病患者81例(男性59例,女性22例,年龄61±11岁),行SFCT(n=37)和普通球囊成形术(POBA,n=44)。所有病例术前、术后即刻行定量冠脉造影(QCA),55例(SFCT组24例,POBA组31例)术前、术后行IVUS。以QCA分析最小管腔直径(MLD)、参照管腔直径(RLD)和管腔直径狭窄百分比(DS);以IVUS分析外弹力膜内横截面积(EEMA)、最小管腔横截面积(MLA)、管腔面积狭窄率(AS)以及内膜撕裂类型和夹层形成。结果SFCT和POBA手术成功率均达到100%,无严重并发症发生。SFCT组平均扩张压力为871.4kPa,小于POBA组的1013.2kPa(P<0.05)。夹层发生率SFCT组为30.5%,POBA组为62.34%(P<0.05)。术后即刻MLA和MLD增大,SFCT组的MLD在介入治疗前后分别为0.67±0.45mm和2.41±0.33mm(P<0.01),MLA分别为1.49±0.61mm2和6.01±3.44mm2(P<0.01);POBA组的MLD在介入治疗前后分别为0.66±0.48mm和2.32±0.51mm(P<0.01),MLA分别为1.47±0.55mm2和5.51±3.02mm2(P<0.01)。SFCT组的MLD即刻获得为1.74±0.34mm,POBA组的MLD即刻获得为1.66±0.49mm(P<0.05);SFCT组的MLA即刻获得为4.52±0.50mm2,POBA组的MLA即刻获得为4.04±0.50mm2(P<0.05)。结论SFCT治疗冠脉狭窄安全有效。
Objective To evaluate the efficacy and safety of SAFE-CUTTM balloon angioplasty （SFCT） by intravascular ultrasound （IVUS） in patients with coronary heart disease （CHD）. Methods Eighty-one patients with coronary artery stenosis 〉70% （59 male and 22 female, mean age 61 ± 11 years） were enrolled in the study, IVUS was done in 55 cases before and after percutaneous coronary intervention （PCI） with 24 patients from the SFCT group and 31 patients from the conventional percutaneous coronary angioplasty （POBA）. Quantitative coronary angiography （QCA） measurements included minimal lumen diameter （ MLD ）, reference lumen diameter （ RLD ） and diameter stenosis （DS） ; IVUS measurements include external elastic membrane area （EEMA）, minimal lumen area （MLA）, and area stenosis （AS）, style of endomembrane tear and dissection. Results All the target lesions were successfully dilated in both groups without serious complications. Mean dilated pressure was lower in the SFCT group than that in the POBA group （871.4 kPa vs 1 013.2 kPa P〈0.05）. A 30.5% and 62.34% dissection was seen in the SFCT group and the POBA group respectively （P 〈 0. 05 ） ; The MLD and MLA were larger after PCI, they were 0.67 ±0.45 mm vs 2.41 ±0.33 nun （P〈0.01） and 1.49 ±0.61 mm^2 vs 6.01 ±3.44 mm^2（p 〈 0. 01 ） for the SFCT group respectively, and they were 0. 66 ±0. 48 mm vs 2. 32 ±0. 51 mm （P 〈0. 01 ） and 1.47 ±0. 55 mm^2 vs 5.51 ±3.02 mm^2（p〈0. 01） for the POBA group before and after PCI. The acute gain of MLD was greater in the SFCT group compared to the POBA group （ 1.74 ± 0. 34 mm vs 1.66 ± 0. 49 mm, P 〈 0. 05 ）. The acute gain of MLA was also greater in the SFCT group （4. 52 ± 0. 50 mm^2 vs 4. 04 ± 0. 50 mm^2 ,P 〈 0. 05 ）. Conclusion SFCT is safe and effective in dealing with coronary artery stenosis.
出处
《中国介入心脏病学杂志》
2007年第1期15-18,共4页
Chinese Journal of Interventional Cardiology
