切割球囊在药物涂层球囊治疗冠脉原位病变时的临床价值

The clinical value of cutting balloon in the treatment of primary coronary lesions with drug-coated balloon

目的探讨切割球囊在药物涂层球囊治疗冠脉原位病变时的临床价值。方法选择2017年8月11日-2020年6月11日上海交通大学医学院附属第九人民医院心内科所有冠脉造影后需要血运重建,适合行冠脉介入治疗(PCI),并且同意行单纯药物涂层球囊的冠心病患者(1月内的急性ST段抬高型心肌梗死除外),共37例,平均年龄(67.2±10.2)岁。在单纯应用药物涂层球囊前,将切割球囊作为预处理策略,观察术中预处理成功率及6个月后的冠脉造影随访结果。结果本组37例患者中,除1例无法到达靶病变外,其他36例(97.3%)均预处理成功。在实现了球囊直径大小和充盈压力管理策略的情况下经过6个月的冠脉造影随访,单纯接受药物涂层球囊的32例患者,有1例再次血运重建(MACE),但非原靶病变。结论通过切割球囊完成冠脉原位病变预处理的控制性球囊成形术,是一种良好的病变准备手段。

Objective To observe and analyze the clinical value of cutting balloon in the treatment of primary coronary lesions with drug-coated balloon.Methods 37 patients with coronary heart disease(except for acute ST segment elevation myocardial infarction within 1 month)who needed revascularization after coronary angiography in the Department of Cardiology of Ninth People’s Hospital of School of Medicine of Shanghai Jiaotong University from August 11,2017 to June 11,2020,were suitable for coronary intervention(PCI),and agreed to accept only drug-coated balloon were selected,with an average age of(67.2±10.2)years.Before the application of drug coated balloon,the cutting balloon was used as the pretreatment strategy.The success rate of intraoperative pretreatment and the follow-up results of coronary angiography after 6 months were observed.Results Among the 37 patients,36 ones(97.3%)were successfully pretreated except one who could not reach the target lesion.In the case of the balloon diameter and filling pressure management strategy,during the 6-month follow-up after coronary angiography,only one of the 32 patients who received drug-eluting balloon suffered from revascularization(MACE)again,but not the original target lesion.Conclusion The controlled balloon angioplasty based on the pretreatment of primary coronary lesions by cutting balloon is a good treatment method for lesions.