血管内超声与冠状动脉造影在冠状动脉支架置入中的应用比较

Intravascular ultrasound versus coronary angiography in coronary artery stent implantation

目的:冠状动脉支架置入已成为治疗冠状动脉狭窄性病变的主要方法,支架治疗策略的选择成为主要技术问题,文章对冠脉造影后的血管狭窄分析和血管内超声成像的血管分析应用效价进行探讨。方法:根据文献报道对冠状动脉造影血管狭窄分析及血管内超声在冠脉支架置入前后的应用,结合南昌大学第二附属医院冠状动脉支架置入前后的血管造影及血管内超声的应用进行对比分析。结果:冠状动脉造影对支架置入前后的影像学造影检查,只能观其血管外壁形态、血流变化。对管腔黏膜病变情况、内支架贴壁情况,支架是否完全对称性扩张,以及支架对病变段的覆盖情况,不能精确显示。血管内超声对靶血管的狭窄程度、血管内斑块及黏膜病变情况能够精确实时显示,可实时显示支架是否完全扩张,支架扩张是否均匀对称,支架对血管壁斑块的挤压支撑情况如何。结论:血管内超声在冠脉支架置入前后的应用,较冠状动脉造影更能全面的评价血管内病变情况,对支架的选取策略及支架释放后的评价与指导,防止血管内再狭窄具有重要的意义。

OBJECTIVE： Coronary stent implantation is the main treatment for coronary artery disease, so stent selection becomes the major technical problem. This paper wants to explore the application titer of the coronary angiography in analysis of vascular stenosis and intravascular ultrasound imaging in the vascular analysis. METHODS： Compared angiography in vascular stenosis analysis and intravascular ultrasound application prior to and after stent implantation according to literature reported combined with percutaneous coronary intervention performed at the Interventional Cardiology Room, Second Affiliated Hospital of Nanchang University. RESULTS： Coronary angiography could only watch the vascular wall morphology and blood flow changes prior to and after stent implantation. However, it could not be accurately displayed mucosal lesion of the lumen, stent adherence, symmetry of stent expansion, as well as the lesion coverage of stent segment. Intravascular ultrasound could precise real-time display the target vessel stenosis of blood vessels within the plaque and mucous membrane lesions, stent expansion, extrusion or supporting conditions of symmetrical stent on the vessel wall plaque. CONCLUSION： The application of intravascular ultrasound prior to and after stent implantation can comprehensive investigate ivascular lesions than coronary angiography, which has an important significance in stent selection, post-release evaluation and prevent vascular restenosis.