术前冠状动脉CTA评估支架参数与PCI放置支架参数的对比研究

Stent Parameter of Percutaneous Coronary Intervention:Compared with Preoperative Coronary Computed Tomographic Angiography

目的对比分析术前冠状动脉CTA(CCTA)预估冠状动脉支架参数与冠状动脉介入治疗(PCI)置入支架参数的相关性与差异性。方法采用前瞻性研究方法,分析测量30例患者PCI术前1周内的CCTA图像,对其中50枚病变进行支架直径及长度的预估,并与PCI术中实际放置的50枚支架直径及长度进行比较。结果 (1)CCTA预测的支架直径及长度与PCI术中实际放置的支架直径及长度有明显的相关性(r=0.860,P<0.05;r=0.680,P<0.05);(2)CCTA预测的支架长度与PCI实际放置的支架长度差异有统计学意义(t=-2.680,P<0.05),其中CCTA预测的支架长度大于PCI实际放置的支架长度共43枚(86.0%)。结论 CCTA预测支架参数与PCI有较好的相关性,CCTA预测的支架长度往往大于PCI实际放置的支架长度,应引起临床重视。

Objective To analyze the correlation and difference of stent parameter predicted by using coronary computed tomographic angiography（ CCTA） with that finally implanted in percutaneous coronary intervention（ PCI）. Methods Thirty patients with 50 lesions were enrolled in this prospective study. The stent diameter（ CTA Stent D） and length（ CTA Stent L） were evaluated by using CCTA preoperatively,and compared with the diameter（ CAG Stent D） and length（ CAG Stent L） finally used in PCI. Results（ 1） There were significant correlations between CTA Stent D and CAG Stent D（ r = 0. 860,P 〈0. 05） and between CTA Stent L and CAG Stent L（ r = 0. 680,P 〈0. 05）.（ 2） There was significant statistical difference between the CTA Stent L and the CAG Stent L（ t =- 2. 680,P 〈0. 05）. In 43 lesions（ 86. 0%）,the lengths of CTA Stent L were longer than that of CAG Stent L. Conclusion There are significant correlation between CCTA and CAG based stent sizing in an experienced setting. The lengths of stent predicted by CCTA are longer than that of stent finally implanted,which should be a focus of clinical attention.