冠脉内多普勒血流速度描记评价介入治疗效果

Evaluation of the therapeutic effect of coronary interventions with intracoronary Doppler flow velocity recording.

目的 应用冠状动脉内多普勒血流速度描记技术 ,评价经皮冠状动脉球囊扩张术 (PTCA)及支架植入术对冠脉血流储备的影响。方法 对 2 1支 (1 8例 )有狭窄病变的冠状动脉进行 PTCA术 ,其中 1 6支冠脉 PTCA术后植入支架。在PTCA前后和支架植入术后 ,采用 Cardiometric Flo Map 血管腔内多普勒血流速度描记仪和多普勒导丝 ,测量狭窄近端和远端的平均峰值流速 (APV)、舒张期与收缩期流速比 (DSVR)、近远端血流速度之比 (P/ DVR)、冠脉血流储备 (CFR)。其中 1 0例同时有 PTCA前后和支架后的测值。结果 2 1支冠脉的直径狭窄率为 (81 .2± 1 4 .4) %。PTCA前、PTCA后、植入支架后狭窄近端 APV差别无显著意义 (P>0 .0 5 )。 PTCA后狭窄远端 APV显著增加 (P<0 .0 5 ) ,植入支架后 APV进一步增加 (P=0 .0 1 )。PTCA前后 P/ DVR差别无显著意义 ,但植入支架后则明显下降 (P<0 .0 5 )。高峰 APV在 PTCA后非常显著增加 (P<0 .0 1 )。植入支架后增加极显著 (P<0 .0 1 ) ,狭窄远端的 CFR术前较术后明显增高 (P<0 .0 5 ) ,与支架后比较 P<0 .0 1。与PTCA后比较 ,放置支架后狭窄远端 APV、P/ DVR、CFR的差别均无显著意义 ,但高峰 APV有明显提高 (P<0 .0 1 )。结论 冠脉内血流速度描记技术可用于 PTCA及支架植入术中评价?

Objective To evaluate the effect of percutaneous transluminal coronary balloon angioplasty (PTCA) and stent implantation on coronary flow reserve by using intracoronary Doppler flow velocity recording.Methods PTCA was performed on 21 coronary arteries of 18 patients with coronary stenosis lesion and 16 of them underwent adjunctive stent implantation following PTCA. Coronary flow velocity was recorded by using Cardiometric FloMap Ⅱ by introducing the Doppler flowire into the target arteries.The average peak veloity (APV) and coronary flow reserve (CFR) were measured before an after PTCA and after stent implantation.Ten coronary arteries had data both after PTCA and after stent implantation.ResultsThe baseline diameter stenosis was(81 2±14 4)%.The difference between proximal APV at baseline and APV after PTCA or (and) stenting had no significant (P>0 05).The poststenotic APV was increased from initial value after PTCA (P<0 05) and after stenting (P<0 01).There was no significant difference in the proximal/distal velocity ratio (P/DVR) before and after PTCA(P>0 05),but P/DVR was obviously decreased after stenting (P<0 05).The hyperemic APV was significantly increased after PTCA and stenting (both P<0 01).The proximal stenosis CFR was improved after PTCA (P<0 05) and after stenting (P<0 01).There was no significant difference in proximal stenosis APV,P/DVR and CFR between after PTCA and after stenting (P>0 05).Conclusion Intracoronary Doppler flow velocity recording could be used to assess the therapeutic effect during PTCA and stenting.