支架影像增强显影技术在冠脉支架植入术中的应用效果观察

Effective observation of application of stent boost in coronary stent implantation

目的评价支架增强显影(SB)技术在冠脉支架植入术中的应用效果。方法将204例行冠状动脉支架植入术的患者随机分为观察组和对照组,各102例。两组均采用常规冠状动脉造影方法行冠状动脉造影,并在其指导下进行冠状动脉支架植入术。对照组支架植入后采用QCA自动分析系统测量支架直径的相关参数(包括支架直径的最小值、最大值、均值)并计算支架偏心指数。同时进行支架可视性和球囊内扩张必要性评分。观察组在支架植入后行SB,测量上述指标并进行上述评分。观察组26例支架植入后行血管内超声(IVUS)检查,测量上述指标并进行上述评分。结果对照组支架植入后支架可视性得分低于观察组,P<0.05。对照组发现30处、观察组发现48处有球囊内扩张必要性而行支架球囊内扩张术。两组QCA、SB、IVUS测得植入支架最小直径、最大直径、直径均值和支架偏心指数差异无统计学意义。Pearson相关性分析显示QCA与SB、QCA与IVUS、SB与IVUS测得支架最小直径均有良好的相关性,r分别为0.772、0.775、0.782,P均<0.05。结论 SB可明显提高支架的可视性,有效指导支架的球囊内扩张,在测量支架直径方面甚至可以替代冠脉内超声。

Objective To evaluate the application effect of Stent Boost （ SB） in coronary stent implantation .Methods A total of 204 consecutive patients were randomly divided into the observation group （n=102） and control group （n=102）. Coronary angiography were performed in the two group and coronary stents were implanted which were guided by coronary an -giography .Diameter parameters （ including maximum , minimum and average ） were measured by quantitative coronary angiog-raphy （QCA）, the ratio （maximum stent diameter （MaxLD）-minimum stent diameter （MinLD））/MaxLD） was calculated. Stent visibility and the need for post dilatation was assessed at the same time .SB was performed after stent implantation and the parameters were measured in the observation group , stent visibility and the need for post dilatation was assessed .Twenty-six patients in the observation group were analyzed by IVUS at the same time .Results The score of stent visibility in the ob-servation group was lower than that of the control group （P〈0.05）.Post dilation after stent implantation was performed in 48 cases of the observation group and 30 cases in the control group .QCA, SB, IVUS of the two groups measured that the mini-mum diameter, the maximum diameter , the average diameter and stent eccentricity index had no statistical significance .Pear-son correlation analysis showed that QCA and SB , QCA and IVUS, SB and IVUS were in good correlations （ r=0.772, 0.775, 0.782, respectively, all P〈0.05）.Conclusion SB increases the stent visibility and effectively guides the post dil-atation.Meanwhile, SB can even take the place of IVUS in the term of measuring tent diameter .