CAJ | 학술논문

目的：血管内超声评价旋磨术联合切割球囊成形术治疗冠状动脉重度钙化病变的安全性及有效性。方法收集冠状动脉造影及血管内超声检查确认至少1处病变为高度钙化，并行旋磨术处理的冠心病患者80例，根据是否使用切割球囊分为单纯旋磨组34例和旋磨联合切割组46例。患者在支架置入前及置入后均行血管内超声检查，评价支架置入效果。结果单纯旋磨组与旋磨联合切割组最大钙化弧度分别为（215．88±21．81）°vs（226．55±21．59）°，钙化长度比为（0．72±0．06）vs（0．78±0．05），支架置入前最小管腔面积为（2．52±0．07）mm2vs（2．46±0．09）mm2，2组比较差异无统计学意义（P＞0．05）。支架置入后，旋磨联合切割组最小支架面积（6．12±0．37）mm2和即刻管腔获得面积（3．66±0．34）mm2，单纯旋磨组分别为（5．42±0．24）mm2和（2．90±0．24）mm2，2组比较差异有统计学意义（P＝0．016）。2组术中并发症的发生比例比较，差异无统计学意义（P＞0．05）。结论在冠状动脉重度钙化病变中，使用旋磨术联合切割球囊成形术可以获得更好的支架置入后效果。
목적：혈관내초성평개선마술연합절할구낭성형술치료관상동맥중도개화병변적안전성급유효성。방법수집관상동맥조영급혈관내초성검사학인지소1처병변위고도개화，병행선마술처리적관심병환자80례，근거시부사용절할구낭분위단순선마조34례화선마연합절할조46례。환자재지가치입전급치입후균행혈관내초성검사，평개지가치입효과。결과단순선마조여선마연합절할조최대개화호도분별위（215．88±21．81）°vs（226．55±21．59）°，개화장도비위（0．72±0．06）vs（0．78±0．05），지가치입전최소관강면적위（2．52±0．07）mm2vs（2．46±0．09）mm2，2조비교차이무통계학의의（P＞0．05）。지가치입후，선마연합절할조최소지가면적（6．12±0．37）mm2화즉각관강획득면적（3．66±0．34）mm2，단순선마조분별위（5．42±0．24）mm2화（2．90±0．24）mm2，2조비교차이유통계학의의（P＝0．016）。2조술중병발증적발생비례비교，차이무통계학의의（P＞0．05）。결론재관상동맥중도개화병변중，사용선마술연합절할구낭성형술가이획득경호적지가치입후효과。
Objective To assess the safety and efficiency of rotational atherectomy (RA ) and cut-ting balloon (CB) angioplasty for severe calcified coronary lesions according to intravascular ultra-sound (IVUS) .Methods Eighty CHD patients with at least one severe calcified coronary lesion detected by coronary angiography ,IVUS and RA were divided into RA group (n=34) and com-bined RA and CB angioplasty group (n=46) .The patients underwent IVUS before and after stent implantation .The outcome of stent implantation was assessed in the patients .Results The mean calcium arc and the mean calcium length ratio were lower in RA group than in combined RA and CB angioplasty group (215 .88 ± 21 .81° vs 226 .55 ± 21 .59° ,0 .72 ± 0 .06 vs 0 .78 ± 0 .05 ,P<0.05) .No significant difference was found in the minimum lumen area between the two groups before stent implantation (2 .52 ± 0 .07 mm2 vs 2 .46 ± 0 .09 mm2 ,P>0 .05) .The minimum stent area and acute lumen gain area were significantly larger in ombined RA and CB angioplasty group than in RA group after stent implantationin (6 .12 ± 0 .37 mm2 vs 5.42 ± 0 .24 mm2 ,3 .66 ± 0 .34 mm2 vs 2 .90 ± 0 .24 mm2 ,P=0 .016) .Conclusion Combined RA and CB angioplasty can achieve better stent implantation outcomes in patients with severe calcified coronary lesions .