紫杉醇涂层球囊在非ST段抬高型急性冠状动脉综合征患者中的应用观察

Outcomes with paclitaxel-coated balloons in non-ST segment elevation acute coronary syndrome

目的:评价紫杉醇涂层球囊(PCB)在非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者中应用的安全性和有效性。方法:我们回顾了在2017年1月至2019年7月间,使用PCB介入治疗的NSTE-ACS患者,观察指标包括:晚期管腔丢失,再狭窄、靶病变的血运重建,心肌梗死,心源性死亡,非心源性死亡和MACE事件等。结果:共有87例NSTE-ACS患者接受了PCB治疗,包含病变91处,其中PCB的直径为(3.05±0.71)mm,长度为(16.77±8.67)mm,扩张压力(8.60±2.84)atm(1 atm=101.325 kPa);有6例(6.9%)患者实行了补救性支架置入术,1(1.2%)例患者在术后观察期间发生了冠状动脉急性闭塞,行IVUS检查提示冠状动脉夹层闭塞,随后置入支架;在随访期间,定量冠状动脉造影计算晚期管腔丢失直径为(0.07±0.58)mm,定义的再狭窄为10例(12.5%),靶病变血管重建为3例(3.6%),无MACE事件发生。结论:如果预处理情况适合,单独使用PCB介入来处理NSTE-ACS的患者,是一个安全、有效的措施。

Objective:To explore the effectiveness and safety of paclitaxel-coated balloons(PCB)in the patients of non-ST segment elevation acute coronary syndrome(NSTE-ACS).Methods:We prospectively analyzed all patients of NSTE-ACS treated with PCB consistent with inclusion criteria between January 2017 and July 2019.The observed outcome measures included target lesion revascularization(TLR),late lumen loss(LLL),binary restenosis(RS),myocardial infarction,cardiac death and non-cardiac death,and major adverse cardiac events(MACE).Results:A total of 87 patients with NSTE-ACS including 91 lesions were treated with PCB,the diameter and length of PCB were(3.05±0.71)mm and(16.77±8.67)mm respectively.6(6.9%)bailout drug-eluting stents were used in the process of percutaneous coronary interventions due to coronary artery dissection.1(1.2%)acute coronary artery closure occurred during hospitalization and was successfully treated by stent implantation.83 patients participated in the follow-up,quantitative coronary angiography measurement at follow-up showed that LLL(0.07±0.58)mm.The binary restenosis rate was 12.5%.The TLR rate and overall MACE rates were 3.6%and 0 respectively.Conclusions:The"PCB-only"strategy is safe and efficient in the patients of NSTE-ACS whose predilation achieved an acceptable result.