冠状动脉内药物洗脱支架置入通过困难不同锚定方法的对比

Comparison of different anchoring techniques for intracoronary delivering of drug-eluting stents to target lesions

背景:边支球囊锚定和远端钢丝锚定是提高冠状动脉内支架通过到位率的有效办法,目前国内尚无比较上述两种锚定方法在提高支架通过成功率方面的研究。目的:比较边支球囊锚定和远端钢丝锚定在提高冠状动脉介入治疗药物洗脱支架通过困难方面的临床效果。方法:纳入87例冠状动脉介入治疗过程中药物洗脱支架通过困难病例,随机分2组治疗,其中46例采用边支球囊锚定方法提高支架通过到位率,41例采用远端钢丝锚定方法提高支架通过到位率。对比两组患者支架置入成功率,以及支架置入12个月内的支架材料生物相容性问题,包括主要不良心脏反应、再发心绞痛、支架再狭窄和晚期管腔丢失等。结果与结论:远端钢丝锚定组药物洗脱支架置入成功率明显高于边支球囊锚定组(83%,61%,P<0.05),两组患者药物洗脱支架置入过程中并发症及支架置入12个月内的主要不良心脏反应、再发心绞痛、支架再狭窄和晚期管腔丢失结果比较差异无显著性意义(P>0.05)。说明远端钢丝球囊锚定方法在不影响支架材料生物相容性的情况下,更有利于提高冠状动脉支架通过率。

BACKGROUND：Both distal-wire anchoring technique and branch-baloon anchoring technique are the effective ways of improving the ability to deliver stents to the target lesions. There is no study addressing the comparison of these two techniques in the successful stent delivery to stenosis lesions at present. OBJECTIVE： To evaluate the clinical effect of distal-wire anchoring techniqueversus branch-baloon anchoring technique in delivering stents to complex lesions. METHODS：We retrospectively analyzed the clinical data of 87 cases of difficultly delivering stents in the process of coronary intervention, in which 46 cases were treated with branch-baloon anchoring technique and 41 cases treated with distal-wire anchoring technique. Then, stent implantation rate, major adverse cardiac reactions and recurrence of angina pectoris within 12 months, and late lumen loss, restenosis after stent implantation were compared between the two groups. RESULTS AND CONCLUSION：The successful stenting rate of distal-wire anchoring technique group was significantly higher than that of branch-baloon anchoring technique group （83%vs. 61%,P〈 0.05）. There were no significant differences between two groups patients in complications during stenting, major adverse cardiac reactions and recurrence of angina pectoris within 12 months, and late lumen loss, restenosis after stent implantation. The study indicates that the distal-wire anchoring technique is of safety and effectiveness method for dealing with inability to deliver stents to the target lesions.