药物涂层球囊治疗新生冠状动脉病变45例临床分析

Drug-coated balloon for the treatment of de novo coronary lesions: clinical analysis of 45 patients

目的探讨药物涂层球囊(DCB)治疗新生冠状动脉病变的可行性、有效性和安全性。方法回顾性分析2017年4月至2018年8月宣城市人民医院45例新生冠状动脉病变患者DCB介入治疗过程及其临床和影像学随访结果。结果手术成功率为100%。术后定量冠状动脉造影(QCA)分析显示急性管腔内径增加(1.67±0.29) mm,即刻残余狭窄为(17.78±7.94)%。术后9~12个月复查冠状动脉造影显示远期管腔丢失(0.12±0.21) mm。术后12~30个月临床随访显示,4例(8.9%)发生靶血管血运重建(TVR),其中2例在靶病变。未发生心源性死亡、非致死性目标血管心肌梗死或靶血管血栓形成。结论 DCB治疗新生冠状动脉病变可行且安全有效,随访期主要不良心脏事件发生率低,提示DCB可作为新生冠状动脉病变介入治疗的良好选择。

Objective To investigate the feasibility, efficacy and safety of drug-coated balloon(DCB) in treating de novo coronary lesions. Methods The clinical data, including the process of interventional therapy, the clinical and imaging follow-up results, of 45 patients with de novo coronary lesions, who received DCB during the period from April 2017 to August 2018 at the Xuancheng Municipal People’s Hospital of China, were retrospectively analyzed. Results The surgical success rate was 100%. Postoperative quantitative coronary angiography(QCA) analysis showed that the inner diameter of the lumen was immediately increased by(1.67 ±0.29) mm and the residual stenosis was(17.78 ±7.94)%. Within 9-12 months after DCB,coronary angiography revealed that long-term lumen diameter was reduced by(0.12 ±0.21) mm. Follow-up reexamin-ations during 12-30 months after DCB showed that 4 patients(8.8%) obtained revascularization of target blood vessels, in two of them the revascularization took place in the target lesion site. No cardiogenic death, non-fatal target vascular myocardial infarction or target vascular thrombosis occurred. Conclusion For the treatment of de novo coronary lesions, DCB is feasible, safe and effective, the incidence of major adverse cardiac events during follow-up period is very low, indicating that DCB is an excellent choice for the treatment of de novo coronary lesions.