经皮冠状动脉血管内冲击波钙化碎裂术治疗冠状动脉严重钙化病变的临床体会

Effect of Shockwave intravascular lithotripsy in patients with high coronary artery calcification

目的总结经皮冠状动脉血管内冲击波钙化碎裂术(intravascular lithotripsy,IVL)治疗冠状动脉严重钙化病变的临床诊治体会。方法回顾性分析2022年9月至2022年11月在中国人民解放军总医院第七医学中心施行经皮冠状动脉血管内IVL治疗的3例冠状动脉严重钙化患者的临床资料。结果病例1为左前降支严重、弥漫、成角钙化,长病变;病例2为右冠状动脉慢性完全闭塞、严重、弥漫钙化,长病变;病例3为左前降支严重、局限钙化病变。3例患者均使用Shockwave C2导管经皮冠状动脉进行IVL治疗,其中病例2采用了斑块旋磨+IVL联合治疗,3例患者均手术成功,无并发症发生。结论冠状动脉钙化贯穿于各种复杂病变,经皮冠状动脉血管内施行IVL治疗可提高介入成功率,减少介入并发症,改善患者的预后。

Objective To analyse the effect of Shockwave Intravascular lithotripsy in patients with high coronary artery calcification.Method The clinical data of three patients with severe coronary artery calcification treated with percutaneous coronary endovascular IVL performed in the Seventh Medical Center of the PLA from September 2022 to November 2022 were reviewed.Result Among three patients,case 1 with LAD lesion,the characteristics of calcification was severity,diffusion,angulation and length,Case 2 with RCA-CTO lesion,the characteristics of calcification was severity,diffusion and length.Case 3 with LAD lesion,the characteristics of calcification was severity and segment.Three patients with Intravascular lithotripsy,one patient with Rotational Atherectomy and Intravascular lithotripsy.The procedures of three patients were all succeeded,no procedure complication.Conclusion The coronary artery calcification is often throughout the various complex lesion,Intravascular lithotripsy increases success rate,reduces complication and improves the patient’s outcomes.