血管内超声指导下冠状动脉内旋磨术联合药物洗脱支架治疗严重钙化病变

Efficiency of Rotational Atherectomy with Drug-eluting Stents by Intravascular Ultrasound for Heavily Calcified Lesions

目的:评价血管内超声指导下冠脉内旋磨术联合药物洗脱支架治疗严重钙化病变的疗效。方法:17例患者23处严重钙化病变在血管内超声指导下行旋磨术与药物洗脱支架治疗。观察治疗的即刻成功率及随访结果。结果:所有患者均成功进行了旋磨术与血管内超声指导下的药物洗脱支架植入,手术成功率100%。最小管腔直径由(0.71±0.28)mm增加到(3.24±0.48)mm(P<0.05);直径狭窄率由(88.40±7.82)%缩减到(5.26±10.41)%(P<0.01)。21处病变只选择了1个磨头,占91.30%。9例患者(52.34%)完成了9个月造影复查,无明显支架内再狭窄。结论:血管内超声指导下,冠状动脉内旋磨术联合药物洗脱支架可安全用于冠状动脉严重钙化病变,提高介入治疗成功率。

Objective To evaluate the efficiency of rotational atherectomy（RA） with drug-eluting stents（DES） by intravascular ultrasound（IVUS） for heavily calcified lesions.Methods 17 patients with 23 heavily calcified lesions underwent the treatment of RA and DES by IVUS.We wanted to observe the immediate success rate and the follow-up results.Results All the burrs passed through the lesions successfully,34 DES were planted,the immediate success rate was 100%.The minum lumen diameter was changed from（0.71±0.28） mm to（3.24±0.48） mm（P0.05）,the diameter stenosis rate decreased to（5.26±10.41）% from（88.40±7.82）%（P0.01）.Only 1 burr was used for one lesion of all 21 lesions.9 patients（52.34%） received coronary angiograpy（CAG） again after 9 months,the re-stenosis was 0.Conclusion The combination of RA and DES by IVUS was efficiently for heavily calcified lesions and may increase the success rate of the procedure.