4例冠脉复杂病变的血管内超声表现

Intravascular ultrasound findings on 4 cases with coronary complex disease

目的分析和探讨冠脉复杂病变的血管内超声(IVUS)表现,为类似疾病的介入治疗策略提供参考。方法 4例冠脉复杂病变患者行血管内超声检查,分析其对介入治疗的临床应用价值。结果病例1(冠脉穿孔病变),IVUS可准确评价穿孔位置,缺口大小及周边管腔情况,为下一步处理提供参考;病例2、3(冠脉慢性闭塞病变),通过IVUS评估,借助指引导丝,找到真腔位置;病例4(严重钙化病变或偏心斑块病变),IVUS确定钙化斑块的存在、范围、分布及偏心指数,为介入治疗策略的制定提供依据。结论血管内超声对冠脉复杂病变的介入治疗有重要指导意义。

Objective To analyze and discuss the results in complex coronary artery lesions with intravascular ultra- sound, provide the reference for the interventional treatment of similar diseaies. Methods Four cases with complex coronary artery lesions were treated with intravascular ultrasound, and then the clinical application value of the inter- ventional therapy was analyzed. Results For the first case （coronary perforations） IVUS can accurately evaluate the po- sition, size and surrounding the lumen, providing reference for the next step of treatment; For the 2th, 3th cases（coro- nary chronic total occlusion） the true lumen position were find by IVUS with the help of guide; For the 4th case（heavily calcified lesions or eccentric plaque lesions） IVUS determines the presence of calcified plaque, scope, distribution and eccentricity index, provides the basis for the development of intervention strategies. Conclusion IVUS provides impor- tant reference intervention strategies for complex coronary artery lesions.