药物涂层球囊在冠状动脉原位大血管病变中的应用效果

Application Effect of Drug-Coated Balloon in Coronary Artery in Situ Large Vessel Disease

目的:探讨药物涂层球囊(DCB)在冠状动脉原位大血管病变中的应用效果。方法:回顾性分析2020年1月至2021年1月在宁德师范学院附属宁德市医院治疗的64例冠状动脉原位大血管病变患者的临床资料,所有患者均行DCB介入治疗,分析各项手术指标,术前、术后即刻、术后6个月行冠状动脉造影检查,测定冠状动脉靶血管病变处最小管腔直径(MLD),计算管腔狭窄程度,统计术后6个月内主要不良心血管事件(MACE)和靶血管再狭窄情况,计算晚期管腔丢失(LLL)。结果:DCB介入治疗中,扩张压力(8.45±1.78)atm、扩张时间(51.67±12.92)s、最小管腔直径(1.08±0.39)mm、参考血管直径(3.12±0.30)mm、预扩球囊直径(3.00±0.35)mm、预扩张压力(13.98±3.09)atm、DCB直径(3.20±0.23)mm、DCB长度(22.07±5.18)mm、补救支架置入1例(1.56%)。术后即刻、术后6个月,患者的MLD明显大于术前,管腔狭窄程度明显低于术前,差异具有统计学意义(P <0.05)。术后随访6个月,复查冠状动脉造影,LLL在(0.06±0.01)mm,发生靶病变再次血运重建(TLR)2例(3.13%),无靶血管再狭窄病例,均未发生非致死性心肌梗死和全因死亡事件。结论:DCB在冠状动脉原位大血管病变中的应用效果显著,能有效扩张病变大血管,恢复冠状动脉血供,降低靶血管LLL,且安全性高,MACE率低。

Objective To investigate the effect of drug-coated balloon (DCB) in the treatment of coronary artery disease in situ large vessel disease.Methods The clinical data of 64 patients with coronary avtery in situ large vessel diseage who were treated in Ningde Hospital Affiliated to Ningde Normal University from January 2020 to January 2021 were retrospectively analyzed.All patients received interventional treatment with DCB,and all surgical indicators were analyzed.Coronary angiography was performed before surgery,immediately after surgery,and 6 months after surgery.The minimum lumen diameter (MLD) of coronary artery target vessel was measured,the degree of lumen stenosis was calculated,major adverse cardiovascular events (MACE) and target vessel restenosis within 6 months after operation were counted,and late lumen loss (LLL) was calculated.Results In the interventional treatment of DCB,dilation pressure (8.45±1.78) ATM,dilation time (51.67±12.92) s,minimum lumen diameter (1.08±0.39) mm,reference vessel diameter (3.12±0.30) mm,pre-dilation balloon diameter (3.00±0.35) mm,pre-dilation pressure (13.98±3.09) ATM,DCB diameter (3.20±0.23) mm,DCB length (22.07±5.18) mm,remedial stent placement in 1 case (1.56%).Immediately and 6 months after surgery,the MLD of the patient was significantly higher than that before surgery,and the degree of lumen stenosis was significantly lower than that before surgery,with statistically significant differences (P < 0.05).The LLL was 0.06±0.01 mm in 2 patients (3.13%).There was no target vessel restenosis.No non-fatal myocardial infarction or all-cause death occurred.Conclusion DCB can effectively dilate the diseased large vessels,restore coronary blood supply,and reduce the LLL of target vessels.It has high safety and low MACE rate,and has positive clinical significance.