中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
6期
462-465
,共4页
崔锦钢%杨跃进%吴永健%乔树宾%徐波%袁晋青%陈珏%刘海波%尤世杰
崔錦鋼%楊躍進%吳永健%喬樹賓%徐波%袁晉青%陳玨%劉海波%尤世傑
최금강%양약진%오영건%교수빈%서파%원진청%진각%류해파%우세걸
冠状动脉疾病%钙质沉着症%心脏导管插入术%桡动脉
冠狀動脈疾病%鈣質沉著癥%心髒導管插入術%橈動脈
관상동맥질병%개질침착증%심장도관삽입술%뇨동맥
Coronary disease%Calcinosis%Heart catheterization%Radial artery
目的 探讨经桡动脉行冠状动脉斑块旋磨术和药物洗脱支架置入术治疗严重钙化病变的效果.方法 回顾性分析2009年1月至2012年10月经桡动脉行冠状动脉斑块旋磨术和药物洗脱支架置入术治疗的114例连续冠心病患者的临床资料.分析冠状动脉严重钙化病变的特征、手术成功率和并发症,并进行随访.结果 114例(100％)患者均成功经桡动脉行冠状动脉斑块旋磨术,并置入药物洗脱支架.共对120处病变行旋磨处理,均为B或C型严重钙化病变.其中,左主干病变8处,左前降支病变93处,左回旋支病变2处,右冠状动脉病变17处.术中出现无复流或慢血流7例；1例患者发生旋磨头嵌顿后,旋磨头和指引导管一起抽出,未发生严重不良后果.随访6个月(中位数),随访期间11例患者再发心绞痛,其中8例行再次靶病变血运重建,3例予强化药物治疗；未发生急性心肌梗死及死亡.结论 经桡动脉行冠状动脉斑块旋磨术和药物洗脱支架置入术治疗严重钙化病变是一种安全、有效的治疗方法,即时介入操作成功率高,且近期疗效满意.
目的 探討經橈動脈行冠狀動脈斑塊鏇磨術和藥物洗脫支架置入術治療嚴重鈣化病變的效果.方法 迴顧性分析2009年1月至2012年10月經橈動脈行冠狀動脈斑塊鏇磨術和藥物洗脫支架置入術治療的114例連續冠心病患者的臨床資料.分析冠狀動脈嚴重鈣化病變的特徵、手術成功率和併髮癥,併進行隨訪.結果 114例(100％)患者均成功經橈動脈行冠狀動脈斑塊鏇磨術,併置入藥物洗脫支架.共對120處病變行鏇磨處理,均為B或C型嚴重鈣化病變.其中,左主榦病變8處,左前降支病變93處,左迴鏇支病變2處,右冠狀動脈病變17處.術中齣現無複流或慢血流7例；1例患者髮生鏇磨頭嵌頓後,鏇磨頭和指引導管一起抽齣,未髮生嚴重不良後果.隨訪6箇月(中位數),隨訪期間11例患者再髮心絞痛,其中8例行再次靶病變血運重建,3例予彊化藥物治療；未髮生急性心肌梗死及死亡.結論 經橈動脈行冠狀動脈斑塊鏇磨術和藥物洗脫支架置入術治療嚴重鈣化病變是一種安全、有效的治療方法,即時介入操作成功率高,且近期療效滿意.
목적 탐토경뇨동맥행관상동맥반괴선마술화약물세탈지가치입술치료엄중개화병변적효과.방법 회고성분석2009년1월지2012년10월경뇨동맥행관상동맥반괴선마술화약물세탈지가치입술치료적114례련속관심병환자적림상자료.분석관상동맥엄중개화병변적특정、수술성공솔화병발증,병진행수방.결과 114례(100％)환자균성공경뇨동맥행관상동맥반괴선마술,병치입약물세탈지가.공대120처병변행선마처리,균위B혹C형엄중개화병변.기중,좌주간병변8처,좌전강지병변93처,좌회선지병변2처,우관상동맥병변17처.술중출현무복류혹만혈류7례；1례환자발생선마두감돈후,선마두화지인도관일기추출,미발생엄중불량후과.수방6개월(중위수),수방기간11례환자재발심교통,기중8례행재차파병변혈운중건,3례여강화약물치료；미발생급성심기경사급사망.결론 경뇨동맥행관상동맥반괴선마술화약물세탈지가치입술치료엄중개화병변시일충안전、유효적치료방법,즉시개입조작성공솔고,차근기료효만의.
Objective To assess the clinical outcomes of rotational atherectomy followed by drugeluting stenting via the transradial approach for the treatment of heavily calcified coronary lesions.Methods From January2009 to October 2012,114 consecutive patients with heavily calcified coronary lesions underwent rotational atherectomy and drug-eluting stents via transradial approach in our hospital were enrolled in this retrospective study.Characteristics of heavily calcified coronary lesions,the success rates of rotational atherectomy and stenting,rates of complication during perioperation treatments,and adverse cardiovascular events during hospitalization and follow up were analyzed.Results All 114 patients were successfully treated with rotational atherectomy and drug-eluting stent placement,and totally 120 target lesions of type B or C were treated including 8 left main lesions,93 left anterior descending and 2 circumflex,17 right coronary lesions.No-refiow was observed in 7 patients during the procedure,there was one case of entrapped rotablator burr which was successfully retrieved together with guiding catheter without serious complication.During the 6 months (median) follow-up,angina was reported in 11 patients and revascularization was performed in 8 patients due to stent restenosis and intensified medical therapy was applied in 3 patients.There was no acute myocardial infarction and death during follow-up.Conclusion Rotational atherectomy followed by drug-eluting stenting via transradial approach is feasible,effective and safe and the short-term outcome is satisfactory for patients with heavily calcified coronary lesions.
