拘禁球囊技术在PCI边支保护时的应用

The Application of the Technique in the Protection of PCI

目的探讨在经皮冠脉介入治疗(PCI)术时,比较应用拘禁球囊主动与被动扩张技术对边支保护的效果.方法 78例冠脉真性分叉病变患者使用拘禁球囊技术对边支进行保护,分为边支球囊主动扩张组(n=41)和边支球囊补救性扩张组(n=37)2组,观察分析边支血流的TIMI分级、心肌灌注分级(MBG)、TIMI心肌灌注分级(TMP)和边支血管夹层发生率等指标.结果完成主支支架置入后,边支TIMI、MBG及TMP分级达到3级的边支球囊主动扩张组患者比例达到93%,边支球囊补救性扩张组为84%,差异无统计学意义(P>0.05);主动扩张组边支血管夹层发生率为24%,边支球囊补救性扩张组为8%,差异有统计学意义(P<0.05).结论使用拘禁球囊技术对边支进行保护时,边支球囊主动扩张与边支球囊补救性扩张均能够很好的降低主支支架置入后边支血管血流明显减慢甚至阻断的风险,但边支球囊补救性扩张组地边支血管夹层发生率更低.

Objective To explore the treatment of percutaneous coronary intervention（PCI）, and to comparatively study on the protection of side support by using the active and passive expansion technique.Method 78 patients with coronary artery disease were protected by using balloon technique, there were two groups： the active expansion group（n=41） and the side support balloon（n=37）, the TIMI classification、myocardial perfusion rating（MBG）, TIMI myocardial perfusion rating（TMP） and the incidence of marginal vascular interlayer were observed and analyzed. Results After the main support was put in, the proportion of patients with side branches of TIMI、 MBG and TMP was at level 3 and the proportion of patients with active balloon expansion was 93%, the margin expansion group was 84%, the difference was not statistically significant（P〉0.05）; the incidence of intersecting vascular interlayer in active dilatation group was 24%, the margin expansion group was 8%, and there were statistical differences（P〈0.05）. Conclusions Using the technique of holding balloon to protect the side branches,both the active expansion of the side support balloon and the expansion of the side support balloon can significantly reduce the risk of the main stent placement in the posterior branch of the blood vessel, however the incidence of side branch vascular interlayer was lower.