药物涂层球囊治疗右锁骨下动脉盗血综合征的有效性和安全性

Drug-coated balloon for the treatment of right subclavian artery steal syndrome: analysis of its efficacy and safety

目的 评价药物涂层球囊(DCB)治疗右锁骨下动脉盗血综合征的有效性和安全性。方法 回顾性分析2017年4月至2019年10月在衢州市人民医院接受DCB治疗的30例右锁骨下动脉盗血综合征患者临床资料。主要观察终点为靶血管一期通畅率,次要观察终点为二期通畅率、临床症状改善率、临床驱动的靶病变血运重建(TLR)及术后30 d内脑卒中、死亡等事件。结果 术中补救性支架植入率为13.3%(4/30)。术后临床症状缓解率为83.3%(25/30),血管平均狭窄程度较术前明显改善(39.4%比75.3%),患侧/健侧肱动脉收缩压差较术前下降[(34.0±5.3) mmHg比(15.0±2.1) mmHg],差异均有统计学意义(P<0.01)。30 d内无新发脑卒中、死亡患者。术后1年一期通畅率为84.6%(22/26),二期通畅率为92.3%(24/26)。TLR比例为7.7%(2/26)。结论 DCB治疗右锁骨下动脉盗血综合征患者具有良好的近中期效果和安全性。

Objective To evaluate the effectiveness and safety of drug-coated balloon(DCB) in treating right subclavian artery steal syndrome. Methods The clinical data of 30 patients with right subclavian artery steal syndrome, who received DCB treatment at the Quzhou Municipal People’s Hospital of China between April 2017 and October 2019, were retrospective analyzed. The main observation endpoint of this study was the primary patency rate of target vessels. The secondary observation endpoints included secondary patency rate, clinical symptom improvement, target lesion-vessel revascularization(TLR), the events of death and stroke occurring within 30 days after surgery, etc. Results The intraoperative salvage stent implantation rate was 13.3%(4/30). The postoperative clinical symptom remission rate was 83.3%(25/30). The postoperative mean vascular stenosis ratio was 39.4%, which was significantly better than preoperative 75.3%(P<0.01). The mean systolic pressure difference between affected side brachial artery and healthy side brachial artery decreased from preoperative(34±5.3) mmHg to postoperative(15±2.1) mmHg(P<0.01). No newly-developed stroke or death occurred within 30 days after treatment. One year after treatment, the primary patency rate was 84.62%(22/26)and the secondary patency rate was 92.31%(24/26). The TLR ratio was 7.69%(2/26). Conclusion For patients with right subclavian artery steal syndrome, DCB is a safe treatment with satisfactory mid-term effect.