冠状动脉口部病变介入治疗中Szabo技术应用的安全性和可行性

Safety and feasibility of Szabo technique in percutaneous coronary intervention of ostial lesions

目的分析冠状动脉口部病变PCI中造影和血管内超声(intra vascular ultrasonography,IVUS)结果 ,评价Szabo技术的成功率、安全性和可行性。方法回顾性分析Szabo技术治疗冠状动脉口部病变患者39例PCI结果。结果经桡动脉途径31例(79.5%),经股动脉途径8例(20.5%)。罪犯血管为左前降支26例(66.7%),右冠状动脉5例(12.8%),左回旋支及钝缘支3例(7.7%),后降支5例(12.8%)。支架置入后,对30例(76.9%)罪犯血管和9例(23.1%)边支血管进行了IVUS检查。手术成功36例(92.3%)。所有患者造影成功率为100%。IVUS检测罪犯血管准确支架置入到口部患者29例(96.7%)和支架近端轻度凸出患者1例(3.3%)。结论 Szabo技术用于冠状动脉口部病变PCI中是安全可行的,而且具有极高的造影成功率。经过IVUS检查证实大部分支架在冠状动脉口部病变处能准确置入。

Objective To evaluate the safety,feasibility and success rate of Szabo technique by ana lysing technical,angiographic and intravascular ultrasonography（IVUS） findings in the percutane- ous coronary intervention（PCI） on ostial lesions of coronary artery disease（CAD）. Methods PCI results in 39 CAD patients with significant lesion at a coronary artery ostium which was treated using Szabo technique were retrospectively analysed. Results The access was radial artery in 31 （79.5%） and femoral artery in 8（20.5 %） patients. The culprit vessel was left anterior descending in 26 （66.7%）, right coronary artery in 5 （ 12.8%）, circumflex-obtuse marginal in 3 （ 7.7 %）, and posterior descending in 5（12.8%）. IVUS was performed through culprit vessel in 30（76.9%） and through side branch in 9 （23.1%） patients after stent implantation. The procedure was technically successful in 36 （92.3G） patients. All technically successful patients had angiographic success （100%）. IVUS examination of culprit vessel showed accurate placement of stent in ostium in 29 patients（96.7%） and slight proximal protrusion of stent in 1（3.3%） patient. Conclusions Szabo technique is safe and feasible for PCI in coronary artery ostial lesions with a high angiographic success rate. There is high percentage of cases with accurate position of stent in ostium confirmed by IVUS.