药物涂层球囊治疗冠状动脉小血管狭窄伴轻度钙化病变的疗效观察

Curative effect of drug-coated balloon in treatment of small coronary artery stenosis complicated by mild calcification

目的 探索药物涂层球囊(DCB)治疗冠状动脉(冠脉)小血管狭窄伴轻度钙化病变的效果。方法 选取中国人民解放军总医院第七医学中心心内科自2019年1月至2022年1月期间收治的80例经冠脉造影(CAG)证实为冠脉小血管狭窄伴轻度钙化的病变,并接受了DCB或药物洗脱支架(DES)治疗的患者作为研究对象。将所有入选病例按治疗方法分为观察组(DCB治疗37例)和对照组(DES治疗43例)。将两组患者术后即刻、12个月的治疗效果、不良心血管事件发生率、出血事件进行对比。结果观察组、对照组术后即刻、术后12个月的治疗效果,靶血管最小管腔直径(MLD)、晚期管腔丢失(LLL)、再血管化(TLR)以及不良心血管事件比较,均无统计学差异(P>0.05);观察组出血事件发生率明显低于对照组(2.7%vs.17.5%,P<0.05)。结论 DCB与DES治疗冠脉小血管狭窄伴钙化病变,具有相似的近期及远期效果,由于更低的出血性事件,DCB可能作为支架植入的替代方案,具有更广阔的应用前景。

Objective To investigate the curative effect of drug-coated balloon(DCB) in treatment of small coronary artery stenosis complicated by mild calcification.Methods The patients(n=80) with small coronary artery stenosis complicated by mild calcification confirmed by coronary angiography(CAG) and received DCB treatment or drug-eluting stent(DES) treatment were chosen from Department of Cardiovascular Medicine in the Seventh Medical Center of Chinese PLA General Hospital from Jan.2019 to Jan.2022.All patients were divided,according to therapies,into observation group(treated with DCB,n=37) and control group(treated with DES,n=43).The immediate and 12-month curative effects,incidence rates of adverse cardiovascular events and bleeding events were compared between 2 groups.Results The comparison in immediate and 12-month curative effects,target minimal lumen diameter(MLD),late lumen loss(LLL),target lesion revascularization(TLR),and adverse cardiovascular events showed no statistical difference between 2 groups(P>0.05).The incidence rates of bleeding events was significantly in observation group than those in control group(2.7% vs.17.5%,P<0.05).Conclusion DCB and DES have similar short-term and long-term curative effects in the treatment of small coronary artery stenosis complicated by mild calcification.Moreover,as DCB treatment with lower incidence rates of bleeding events,it can be an alternative scheme for stent implantation with widely application prospects.