冠状动脉旋磨术应用于非ST段抬高型急性冠脉综合征患者钙化病变的价值及安全性

The value and safety of coronary rotational atherectomy for calcification in NSTE-ACS patients

目的探讨冠状动脉旋磨术在非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者钙化病变经皮冠状动脉介入治疗(PCI)中的价值及安全性。方法回顾分析2019年7月至2020年9月住院接受PCI的NSTE-ACS患者83例的临床资料,按是否行冠状动脉旋磨术分为观察组(19例)和对照组(64例)。比较两组患者即刻手术效果、术中并发症发生率及随访3个月时的主要心血管不良事件(MACE)和并发症。结果观察组术后支架内最小横截面积大于对照组[(7.54±0.51)mm^(2)vs(5.78±0.76)mm^(2)],残余狭窄<20%比例高于对照组(94.73%vs 68.75%),手术时间长于对照组[(164.00±22.00)min vs(96.00±27.00)min],差异有统计学意义(P<0.05,P<0.01)。两组术中并发症发生率和3个月内MACE发生率比较差异无统计学意义(P>0.05)。结论冠状动脉旋磨术可提高NSTE-ACS患者PCI术的即刻效果,且不增加术中并发症和术后3个月MACE发生率,安全性良好。

Objective To explore the effect and safety of coronary rotational atherectomy(CRA)in patients with non-ST segment elevation acute coronary syndrome(NSTE-ACS)undergoing percutaneous coronary intervention(PCI)and its influence on calcific ation.Methods A retrospective analysis was performed on the clinical data of 83 patients with NSTE-ACS received PCI from July 2019 to September 2020.The patients were divided into observation group(n=19)and control group(n=64)according to whether CRA was conducted.The immediate results of operation,the incidence of intraoperative complications,and the main adverse cardiovascular events(MACE)and complications during 3-month follow-up were compared between two groups.Results Compared with those in control group,the minimum cross-sectional area of stent[(7.54±0.51)mm^(2) vs(5.78±0.76)mm^(2)],the proportion of residual stenosis<20%(94.73%vs 68.75%)and operation time[(164.00±22.00)min vs (96.00±27.00)min]significantly increased in observation group(P<0.05,P<0.01).There were no significant differences in the incidences of intraoperative complications and MACE within 3 months between two groups(P>0.05).Conclusion CRA can improve the immediate effect of PCI in NSTE-ACS patients without increasing the incidences of intraoperative complications and MACE.