血管内超声联合冠状动脉造影在左主干病变中的应用价值

Application value of intravascular ultrasound combined with coronary angiography in left main stem lesions

目的研究血管内超声(IVUS)联合冠状动脉造影(CAG)指导改良CRUSH在左主干病变中的应用效果。方法选取我院收治的50例左主干病变拟行改良CRUSH治疗患者,将其中25例接受IVUS+CAG患者纳入IVUS组,25例仅接受CAG检查的患者纳入CAG组。比较两组的应用效果。结果两组左主干病变位置、血管直径、病变长度、前降支狭窄、回旋支狭窄及右冠状动脉狭窄程度比较,差异无统计学意义(P>0.05)。IVUS组支架直径、支架长度、最小管腔直径及最小管腔面积均显著大于CAG组,面积狭窄率显著低于CAG组(P<0.05)。两组支架压力释放以及MACE、全因死亡、心肌梗死、支架内血栓形成发生率比较,差异无统计学意义(P>0.05)。结论 IVUS联合CAG指导改良CRUSH应用于左主干病变较单一CAG可获得更为可靠的诊断依据,具有更高的临床应用价值。

Objective To study the application effect of modified CRUSH guided by intravascular ultrasound (IVUS) combined with coronary angiography (CAG) in left main stem lesions. Methods Fifty patients with left main stem lesions pursuing modified CRUSH enrolled in our hospital were selected. Among the patients, 25 cases received IVUS+CAG were included in IVUS group, while 25 cases received only CAG examination were included in CAG group. The application effects were compared between the two groups. Results There were no significant differences in the location of left main lesion, vessel diameter, lesion length, anterior descending artery stenosis, circumflex artery stenosis and right coronary artery stenosis between the two groups (P>0.05). The stent diameter, stent length, minimum lumen diameter and minimum lumen area in the IVUS group were significantly larger than those in the CAG group, and the area stenosis rate was significantly lower than that in the CAG group (P<0.05). There were no significant differences in stent pressure release, incidences of MACE, all-cause death, myocardial infarction and in-stent thrombosis between the two groups (P>0.05). Conclusion Modified CRUSH guided by IVUS combined with CAG for left main stem lesions can obtain more reliable diagnostic basis than single CAG, and has higher clinical application value.