冠状动脉内超声指导下紫杉醇药物涂层球囊用于治疗冠状动脉狭窄26例近期临床疗效

Clinical effectiveness of paclitaxel drug-coated balloons under intravascular ultrasound-guided in 26 patients with coronary restenosis

目的:研究紫杉醇药物涂层球囊在治疗冠状动脉狭窄病变中的疗效及安全性。方法:入选经冠状动脉造影检查确诊为冠状动脉狭窄的患者26例,对患者的临床资料和近期治疗结果进行分析,总结紫杉醇药物涂层球囊用于治疗冠状动脉狭窄病变的疗效及安全性。结果:26例患者均在冠状动脉内超声指导下采用紫杉醇药物涂层球囊对冠状动脉狭窄行扩张成形术治疗,术中未出现影响血流的夹层。药物涂层球囊扩张时间持续40~60s,平均(50±3)s;药物涂层球囊介入治疗的即刻成功率为100%。患者术后较术前的病变狭窄程度明显减轻[(10.36±7.19)%∶(77.14±6.44)%],血管最小内径明显增加[(2.82±0.07)mm∶(0.74±0.05)mm],差异均有统计学意义(P<0.01)。术后患者住院期间无心绞痛再发、无其他心血管不良事件发生。结论:紫杉醇药物涂层球囊直接用于治疗冠状动脉狭窄病变是安全有效的,为临床提供了一个"有介入无植入"的全新的冠心病治疗的有效手段。冠状动脉内超声检查为药物涂层球囊扩张成形提供了重要的指导作用,保证了介入治疗的效果及安全性。但远期疗效还需进一步随访观察。

Objective：To explore effectiveness and safety of paclitaxel drug-coated balloons in the treatment of patients with coronary stenosis lesions.Method：We selected 26 patients with coronary atherosclerotic heart disease and they had undertook the percutaneous transluminal coronary angioplasty（PTCA）with paclitaxel drug-coated balloon under intravascular ultrasound-guided during August 2015 to July 2017.Result：There were not interlayers which affected blood flow after PTCA with ordinary balloon before the paclitaxel drug-coated balloon angioplasty.The drug-coated balloon expansion continued to 40-60（50±3）seconds in all lesions and the success rate of immediate intervention operation was 100%.The lesion degree of stenosis and lesions minimum diameter before and after operation were statistically different[（10.36±7.19）% vs（77.14±6.44）%,P〈0.01;（2.82±0.07）mm vs（0.74±0.05）mm,P〈0.01].There were no adverse cardiovascular events during hospitalized.Conclusion：It is effectiveness and safety for the paclitaxel drug-coated balloon in the treatment of patients with coronary stenosis lesions.It is a new method that named ＂the intervention without permanent implant＂,but the long-term effectiveness need to be further observed.