切割球囊联合药物涂层球囊在冠脉原发病变中的应用

Application and analysis of cutting balloon combined with drug-coated balloon in de novo coronary artery lesions

目的评价切割球囊联合药物涂层球囊在冠脉原发病变中的应用效果。方法选择2017年8月11日~2020年6月11日行冠脉造影并拟行单纯药物涂层球囊治疗的冠脉原发病变患者,共91例。根据预处理方式的不同,将使用非顺应性或半顺应性球囊预处理的作为对照组(n=54),使用切割球囊预处理的作为观察组(n=37),比较两组在术中的预处理成功率。经过术后6个月的随访,比较两组患者的靶病变再狭窄、主要不良心血管事件发生率。结果对照组的54例患者术中40例预处理成功,观察组37例患者术中36例预处理成功,两组差异具有统计学意义(P<0.05)。与对照组相比,观察组靶血管前降支和其他分支比例较高,回旋支、右冠比例较低,差异具有统计学意义(P<0.05)。对照组的54例患者中38例接受单纯药物涂层球囊治疗。观察组的37例患者中32例接受单纯药物涂层球囊治疗。与对照组比较,观察组预处理成功率较高,差异具有统计学意义(P<0.05)。预处理方式不同对预处理效果的影响具有统计学差异。非(不使用)切割球囊是预处理失败的独立危险因素。经过术后6个月随访,观察组中原靶病变再狭窄0例,非原靶病变血运重建1例。对照组中原靶病变再狭窄3例,非原靶病变血运重建2例,两组对比差异无统计学意义。结论切割球囊完成冠脉原发病变预处理是一种非常良好的的病变准备手段,联合单纯药物涂层球囊后,获得了极低的靶血管失败率和良好的随访效果。

AIM To evaluate the effect of cutting balloon combined with drug-coated balloon in the treatment of de novo coronary artery.METHODS From August 11,2017 to June 11,2020,Ninety-one patients with de novo coronary artery were observed.According to different predilation methods,37 patients predilated with cutting balloon were selected as the observation group and 54 patients predilated with non-compliant or semi-compliant balloon were selected as the control group.The successful rate of predilation in the two groups was compared.After 6 months of follow-up and coronary angiography examination,the incidence of target lesion restenosis and major cardiovascular adverse events in the two groups were compared.RESULTS Thirty-six of the 37 patients were predilated successfully in the observation group and 40 of the 54 patients were predilated successfully in the control group,and there was statistical significance in the success rate of predilation between the two groups(P<0.05).Thirty-two of the 37 patients in the observation group and 38 of the 54 patients in the control group received drugcoated balloon only.The 6-month follow-up found 0 cases of restenosis of original target lesion and 1 case of revascularization of non-original target lesion in the observation group,and 3 cases with restenosis of original target lesion and 2 cases with revascularization of non-original target lesion in the control group,with no significant difference between the two groups.CONCLUSION Cutting balloon is a feasible method as predilation in de novo coronary artery lesion.Combined with drug coated balloon,the target vessel failure rate is extremely low and the follow-up effect is good.