药物涂层球囊治疗冠状动脉药物洗脱支架内再狭窄临床分析

Clinical Analysis on Drug Coated Balloon for Treating In-stent Restenosis of Drug Eluting Stent in Coronary Artery

目的分析药物涂层球囊（DCB）在治疗冠状动脉药物涂层支架内再狭窄病变中的疗效。方法回顾性分析20例冠状动脉药物洗脱支架内再狭窄患者接受药物涂层球囊治疗的临床资料及随访结果。结果 20例患者共21处再狭窄病变接受DCB治疗,术中即刻成功率95.23%,1处病变在应用DCB治疗后并发夹层并出现TIMI 2级血流,然后植入药物洗脱支架（DES）治疗。所有病例术后随访至今无心绞痛再发,未发生主要心血管不良事件。其中12例患者在术后6~9个月接受冠状动脉造影复查,复查时靶病变最小管腔直径与术后即刻直径比较,按病变血管统计,差异无统计学意义（P〉0.05）;合计统计比较差异有统计学意义（P〈0.05）。结论 DCB治疗DES支架内再狭窄即刻及短期疗效肯定,可以作为支架内再狭窄的一种新的治疗手段。

Objective To analyze the efficacy of the drug coated balloon（ DCB） for treating in-stent restenosis of drug eluting stent（ DES） in coronary artery. Methods The clinical data and follow-up results of 20 patients with in-stent restenosis after percutaneous coronary DES implantation were retrospectively analyzed. Results A total of 20 patients with 21 in-stent restenosis lesions underwent DCB treatment,with 95. 23% immediate success rate. After application of DCB treatment,1 lesion complicated with dissection and TIMI grade 2 flow. Afterwards,the implantation of DES was involved. During the follow-up,no angina and major adverse cardiovascular events had occurred in all cases after the operation so far,among which 12 patients received coronary angiography in post-operative 6-9 months. Compared target lesion minimal lumen diameter with post-operative immediate target lesion minimal lumen diameter,the difference was not statistically significant（ P〉 0. 05） by the lesion vessels; but the difference had statistical significance（ P 〈0. 05） by all vessels. Conclusions The immediate and short-term efficacy of DCB for treating in-stent restenosis of DES is positive and reliable. Therefore,it could be a new therapy for the instent restenosis.