IVUS引导下PCI术对慢性完全闭塞性冠状动脉病变患者手术成功率、术后MACE发生率的影响

Effect of IVUS-guided PCI on the Success Rate of Surgery and the Incidence of Postoperative MACE in Patients with Chronic Totally Occlusive Coronary Artery Lesions

目的探究在血管内超声(intravenous ultrasound,IVUS)引导下经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)对慢性完全闭塞性冠状动脉病变患者手术成功率与术后主要心血管不良事件(major adverse cardiovascular events,MACE)发生率的影响。方法选取2020年9月—2021年9月单县中心医院收治的慢性完全闭塞性冠状动脉病变患者92例,根据随机数表法将其均分为研究组和对照组,各46例。研究组患者在IVUS引导下接受PCI术治疗,对照组患者在冠状动脉造影的引导下接受PCI术治疗。对比两组患者的血管病变情况、支架置入情况、手术成功率、PCI术中并发症发生情况与术后MACE发生率。结果研究组支架扩张时最大球囊压力值(1487.68±200.07)kPa、管腔直径最大值(2.31±0.44)mm与PCI术后最小管腔直径值(3.12±0.42)mm均高于对照组(1351.79±174.93)kPa、(2.07±0.36)mm、(2.76±0.35)mm,差异有统计学意义(t=3.468、2.863、4.466,P<0.05);研究组PCI术中并发症与术后MACE的发生率均低于对照组,差异有统计学意义(χ^(2)=4.842、7.256,P<0.05);研究组手术成功率高于对照组,差异有统计学意义(χ^(2)=13.883,P<0.05);两组的血管病变支数与病变位置比较,差异无统计学意义(P>0.05)。结论IVUS在慢性完全闭塞性冠状动脉病变患者的PCI术治疗中具有良好的应用表现,能够有效扩张患者手术期间的管腔直径,对提升手术成功率具有显著效果,有利于降低PCI术中并发症与术后MACE的发生风险。

Objective To investigate the effect of intravenous ultrasound(IVUS)-guided peripheral component interconnect(PCI)on the success rate of surgery and the incidence of major adverse cardiovascular events(MACE)after surgery in patients with chronic totally occlusive coronary artery lesions.Methods 92 patients with chronic total occlusive coronary artery disease admitted to Shan County Central Hospital from September 2020 to September 2021 were selected,and divide them into study group and control group according to random number table method,with 46 patients in each group.Patients in the study group received PCI under the guidance of IVUS,while patients in the control group received PCI under the guidance of coronary angiography.The vascular lesions,stent placement,procedural success rate,occurrence of intraoperative complications of PCI and the incidence of major adverse cardiovascular events(MACE)after the procedure were compared between the two groups.Results The maximum balloon pressure value(1487.68±200.07)kPa,the maximum lumen diameter value(2.31±0.44)mm and the minimum lumen diameter value(3.12±0.42)mm after PCI in the study group were higher than those in the control group(1351.79±174.93)kPa,(2.07±0.36)mm,(2.76±0.35)mm,the difference was statistically significant(t=3.468,2.863,4.466,P<0.05).The incidence of complications during PCI and MACE after PCI in the study group was lower than that in the control group,and the difference was statistically significant(χ^(2)=4.842,7.256,P<0.05).The success rate of surgery in the study group was higher than that in the control group,and the difference was statistically significant(χ^(2)=13.883,P<0.05).There was no significant difference between the number of vascular lesions and the location of lesions between the two groups(P>0.05).Conclusion IVUS has good performance in the treatment of PCI in patients with chronic totally occlusive coronary artery lesions,and can effectively expand the lumen diameter of patients during the procedure,which has a significant effect on improving the success rate of the procedure and helps to reduce the risk of intraoperative complications and postoperative MACE of PCI.