冠状动脉内旋磨术治疗支架内再狭窄

Treatment of in-stent restenosis with rotational atherectomy

目的通过联合应用冠状动脉旋磨术及球囊扩张术对支架内再狭窄的患者进行治疗，探讨其对治疗再狭窄的安全性及有效性。方法对３例冠状动脉支架内再狭窄的病人先行冠状动脉旋磨术，然后以４－６ａｔｍ的低压力行球囊扩张，并对结果进行随访。结果３例病人手术皆获成功，术中１例病人出现短暂的心率减慢未经任何处理迅速自行恢复，其他２例病人未出现其他不良反应。围术期无并发症，术后随访６－１２个月未出现心绞痛、心肌梗死及其他心脏病事件。其中２例病人于术后６个月复查了冠状动脉造影结果显示：靶血管直径的减少与术后即刻造影结果相比小于３０％。结论冠状动脉旋磨术与球囊扩张联合应用是一种安全的和有效的治疗支架内再狭窄的方法。

Objective To evaluate the treatment of in-stent restenosis with rotational atherectomy and balloon angioplasty. Methods The rotational atherectomy and 4 - 6 atm low pressure balloon angioplasty was performed in 3 patients with in-stent restenosis and follow up after treatment. Results All cases were succeeded. The bradycardia occurred in one patient was quickly disappeared without treatment, two other patients were found no effect on heart rate, hemodynamic performance, global LV function, or regional wall motion. No complications, angina, death or other coronary event occurred during the follow up for6-12 months. Two of them was performed coronary angiography after 6 months and showed the diameter of target vessel was less than 30% as compared with that on coronary angiography which performed immedately after operation. Conclusion The management of in- stent restenosis in target vessels using a combination of rotational atherectomy and balloon angioplasty is safe and efficient.