摘要
目的 探讨旋切刀外径与病变特征对后退式旋切导管 (PAC)治疗冠状动脉病变即刻与近期疗效的影响。方法 5 5例冠状动脉病变选用PAC导管治疗 ,其中 17例为支架内再狭窄病变 ,应用定量冠状动脉造影评价即刻和近期疗效。结果 5 5例患者PAC导管的器械成功率为 95 % ,PAC导管最小管腔直径增益 (0 91± 0 5 9)mm ,主要并发症包括血管内膜撕裂 7例、完全闭塞 1例 ,6个月随访造影再狭窄率为 2 7%。使用 2 4mm导管较 2 0mm导管有较大的即刻血管内腔拓宽 ,随访时血管腔直径丢失较少 (但P >0 0 5 )。PAC导管对向心性病变较偏心性病变有更好的即刻效果 ,但 6个月再狭窄率相近 (2 4 %对 30 % ,P >0 0 5 )。结论 PAC导管直径、血管病变特征可能影响PAC导管即刻和近期疗效。
Objective To investigate the effects of cutter size and characteristic of the lesion on clinical and agiographic results in patients undergoing intracoronary intervention with pullback atherectomy device. Methods Fifty-five patients with a variety of coronary lesions, including 17 in-stent restenosis lesions, were selected to receive pullback atherectomy treatment. Quantitative coronary angiography data were obtained before and after the intervention, and follow-up angiography was conducted at the end of 6 months. Results The device success rate was 95%. The maximal luminal diameter gain was (0.91±0.59)mm by PAC. Angiographic complications after PAC included any dissection in 7, and abrupt closure in 1. The binary angiographic restenosis rate at the end of 6 months was 27%. As compared with 2.0 mm cutter, patients with 2.4 mm cutter had higher maximal luminal diameter gain (0.94±0.51 mm vs 0.87±0.70 mm,P=0.681), and less luminal diameter loss (0.57±0.59 mm vs 0.81±0.78 mm,P=0.231) during follow-up angiography. Patients with eccentric lesion had higher maximal luminal diameter gain (1.13±0.53 mm vs 0.64±0.56mm,P=0.002) after PAC, but with comparable minimal luminal diameter (1.97±0.65 mm vs 1.97±0.70 mm, P>0.05) and binary restenosis rate (24% vs 30%, P>0.05) during follow-up angiography. Conclusion Pullback atherectomy is an effective method of plaque removal for coronary artery disease with optimal short-term angiographic results, and large cutter and eccentric lesion seem to come with good immediate and follow-up angiographic results.
出处
《中国介入心脏病学杂志》
2003年第5期254-257,共4页
Chinese Journal of Interventional Cardiology
