BACKGROUND Percutaneous transluminal coronary angioplasty,while an effective intervention,can frequently lead to acute occlusion with severe consequences.Although clinical trials have demonstrated the efficacy of drug...BACKGROUND Percutaneous transluminal coronary angioplasty,while an effective intervention,can frequently lead to acute occlusion with severe consequences.Although clinical trials have demonstrated the efficacy of drug-coated balloons(DCB)in treating acute coronary artery occlusion and in preventing restenosis,there has been limited exploration on the use of DCB in treating de novo lesions in large vessels.Currently,DCB are only recommended for patients with small vessel lesions and in-stent restenosis lesions,those at high risk of bleeding,and other special groups of patients.CASE SUMMARY This report presents a case of successful drug-coated balloon treatment of de novo lesions in large coronary vessels.Postoperatively,the patient demonstrated favorable recovery,with subsequent examination results revealing no significant differences from the previous examination.CONCLUSION The successful treatment of the patient in our case highlights the potential of DCB in the treatment of de novo lesions in large coronary vessels.展开更多
原发病变一词译自“de novo lesion”,“de novo”来源于拉丁文,原意是指从头开始、重新,在介入学中引申为既往未经过干预的狭窄病变。这里的干预包括球囊扩张、支架置入及旋磨、旋切、激光消蚀、放射治疗等斑块减容(debulk)操作。在药...原发病变一词译自“de novo lesion”,“de novo”来源于拉丁文,原意是指从头开始、重新,在介入学中引申为既往未经过干预的狭窄病变。这里的干预包括球囊扩张、支架置入及旋磨、旋切、激光消蚀、放射治疗等斑块减容(debulk)操作。在药物涂层球囊(drug-coated balloon,DCB)的研究中,de novo病变多指除支架内再狭窄、部分小血管病变和特殊的复杂病变(真分叉病变、慢性完全闭塞病变、钙化病变、血栓病变、桥血管病变等)以外的病变,也就是我们日常介入工作中常见的未经干预的病变。展开更多
目的:探究在血管内超声(intravascular ultrasound,IVUS)辅助下药物涂层球囊(drug-coated balloon,DCB)处理冠状动脉(冠脉)原位病变出现冠脉夹层的影响因素。方法:收集2020年1月—2021年6月于郑州大学第一附属医院在IVUS辅助下DCB处理...目的:探究在血管内超声(intravascular ultrasound,IVUS)辅助下药物涂层球囊(drug-coated balloon,DCB)处理冠状动脉(冠脉)原位病变出现冠脉夹层的影响因素。方法:收集2020年1月—2021年6月于郑州大学第一附属医院在IVUS辅助下DCB处理冠脉原位病变患者的临床资料及影像资料进行回顾性分析。根据IVUS下是否观察到冠脉夹层,分为夹层组和无夹层组,使用logistic回归分析夹层的影响因素。结果:共纳入患者99例,其中夹层组较非夹层组有更长的药物球囊长度(30.33 mm vs 22.17 mm,P<0.05),更大的预扩球囊直径/IVUS下病变部位直径(0.92 vs 0.81,P<0.05)和药物球囊直径/IVUS下病变部位直径(0.95 vs 0.88,P<0.05),更低的左心室射血分数(58.23%vs 62.15%,P<0.05),更小的管腔面积(2.74 mm~2 vs 3.61 mm~2,P<0.05)和平均管腔中膜面积(11.53 mm~2 vs 16.79 mm~2,P<0.05)。多因素logistic回归分析结果显示,最小管腔面积(OR=0.498,95%CI:0.270~0.919,P=0.026)、平均管腔中膜面积(OR=0.854,95%CI:0.732~0.997,P=0.046)、药物球囊长度(OR=1.084,95%CI:1.003~1.171,P=0.041)、最大预扩球囊直径/IVUS下病变部位直径(OR=166.968,95%CI:1.712~16 286.265,P=0.029)是夹层发生的影响因素。结论:药物球囊长度、最大预扩球囊直径/IVUS下病变部位直径是DCB处理原位病变冠脉夹层发生的独立危险因素,病变部位最小管腔面积、平均管腔中膜面积是DCB处理原位病变冠脉夹层发生的保护因素。展开更多
基金Supported by Shandong Provincial TCM Science and Technology Development Program Project,No.2019-0481Jining City Science and Technology Key Research and Development Program,No.2021YXNS069.
文摘BACKGROUND Percutaneous transluminal coronary angioplasty,while an effective intervention,can frequently lead to acute occlusion with severe consequences.Although clinical trials have demonstrated the efficacy of drug-coated balloons(DCB)in treating acute coronary artery occlusion and in preventing restenosis,there has been limited exploration on the use of DCB in treating de novo lesions in large vessels.Currently,DCB are only recommended for patients with small vessel lesions and in-stent restenosis lesions,those at high risk of bleeding,and other special groups of patients.CASE SUMMARY This report presents a case of successful drug-coated balloon treatment of de novo lesions in large coronary vessels.Postoperatively,the patient demonstrated favorable recovery,with subsequent examination results revealing no significant differences from the previous examination.CONCLUSION The successful treatment of the patient in our case highlights the potential of DCB in the treatment of de novo lesions in large coronary vessels.
文摘目的:探究在血管内超声(intravascular ultrasound,IVUS)辅助下药物涂层球囊(drug-coated balloon,DCB)处理冠状动脉(冠脉)原位病变出现冠脉夹层的影响因素。方法:收集2020年1月—2021年6月于郑州大学第一附属医院在IVUS辅助下DCB处理冠脉原位病变患者的临床资料及影像资料进行回顾性分析。根据IVUS下是否观察到冠脉夹层,分为夹层组和无夹层组,使用logistic回归分析夹层的影响因素。结果:共纳入患者99例,其中夹层组较非夹层组有更长的药物球囊长度(30.33 mm vs 22.17 mm,P<0.05),更大的预扩球囊直径/IVUS下病变部位直径(0.92 vs 0.81,P<0.05)和药物球囊直径/IVUS下病变部位直径(0.95 vs 0.88,P<0.05),更低的左心室射血分数(58.23%vs 62.15%,P<0.05),更小的管腔面积(2.74 mm~2 vs 3.61 mm~2,P<0.05)和平均管腔中膜面积(11.53 mm~2 vs 16.79 mm~2,P<0.05)。多因素logistic回归分析结果显示,最小管腔面积(OR=0.498,95%CI:0.270~0.919,P=0.026)、平均管腔中膜面积(OR=0.854,95%CI:0.732~0.997,P=0.046)、药物球囊长度(OR=1.084,95%CI:1.003~1.171,P=0.041)、最大预扩球囊直径/IVUS下病变部位直径(OR=166.968,95%CI:1.712~16 286.265,P=0.029)是夹层发生的影响因素。结论:药物球囊长度、最大预扩球囊直径/IVUS下病变部位直径是DCB处理原位病变冠脉夹层发生的独立危险因素,病变部位最小管腔面积、平均管腔中膜面积是DCB处理原位病变冠脉夹层发生的保护因素。
