24例老年冠心病患者经桡动脉冠脉旋磨术的疗效

Therapeutic effect of transradial coronary rotational atherectomy on 24 aged patients with coronary heart disease

目的:前瞻性随访分析经桡动脉旋磨术对老年冠心病(CHD)患者钙化病变的疗效。方法:2012年6月至2014年5月,入选了24例老年冠心病患者,收集其临床、冠状动脉造影(CAG)和经皮冠脉介入(PCI)的资料。随访观察PCI围手术期(桡动脉穿刺开始至出院)及出院后随访期的无复流、冠脉破裂/穿孔、以及死亡、非致死性急性冠脉综合征(ACS)、再次PCI等主要不良心血管事件(MACE)。结果:24例患者均成功经桡动脉实施了冠脉旋磨术及支架植入。围手术期仅发生1例前降支远端夹层和角支闭塞(旋磨导丝所致)(4.17%),无其它MACE现象发生;随访期因肺炎呼吸衰竭死亡1例(4.17%),心绞痛发生1例(4.17%),其余患者均无MACE发生。结论:经桡动脉冠脉旋磨术治疗老年冠心病钙化病变安全、有效、易行。

Objective： 7？0 prospectively follow up and analyze short- and long- term therapeutic effect of transradial rotational atherectomy on calcified lesions in aged patients with coronary heart disease （CHD）. Methods： A total of 24 aged CHD patients were enrolled from June 2012 to May 2014. Their clinical, coronary angiography （CAG） and percutaneous coronary intervention （PCI） data were collected. Major adverse cardiovascular events （MACE）, inclu- ding no reflow, coronary rupture/perforation, death, non fatal acute coronary syndrome （ACS） and repeated PCI etc., were followed up and observed during peroperative period of PCI （from radial puncture starting to discharge） and follow - up period after discharge. Results.. All 24 patients received successful transradial rotational atherectomy and stent implantation. Anterior descending branch distal dissection and diagonal branch occlusion only occurred in one case （4. 17%） during peroperative period （caused by rotational atherectomy guidewire）, and there were no oth- er MACE occurred. During followup, one case （4.17%） died because respiratory failure caused by pneumonia and one case （4.17%） occurred angina pectoris, MACE didn＇t occur in other patients. Conclusion.. Transradial rotational atherectomy is safe, effective and easy to perform in aged patients with coronary heart disease and calcified lesions.