高频旋联合物洗脱支架植入术治疗冠状动脉严重钙化的疗效.pdfVIP

.417 • 浙江临床医学2016年3月第18卷第3期 高频旋磨联合药物洗脱支架植入术 治疗冠状动脉严重钙化的疗效 刘燕沈都未正炎赵勇刘小娟 [摘要] 目的 评价冠状动脉内旋磨术联合药物洗脱支架治疗冠状动脉严重钙化病变的疗效。方法 32古J 冠状动脉严重钙化病变患者行 冠状动脉内旋磨术联合药物洗脱支架植入水，观察其即刻造影成功率及住院期间不良心血管事件发生率。结果 冠状动脉造影结果均为B2， C型严重钙化病变。旋磨头均成功通过病变，所有患者均在旋磨术后植入药物洗脱支架。病变由术前狭窄( 89.3 士 7.8) %减至术后残余狭窄 (8.2:!: 1.7) %，术后即刻造影成功率100%υ1例 (3.1% )术中出现旋磨头断裂; 8例 (25% )术后出现肌钙蛋白I升高3倍正常值上限，符合 非Q波心肌梗死; 1 例( 3.1%) 术后24h死亡.死亡原因考庭为腹膜后血肿导致失血性休克;无冠状动脉症孪、冠状动脉穿-11..、慢血流、无复 流、急性再次介入治疗及急诊冠状动脉旁路移植木 (CABG) 。结论 冠状动脉内旋磨术联合药物沈脱支架植入术治疗冠状动脉严重钙化病 变并发症少，成功率高，安全可行。 [关键词】 冠状动脉钙化旋磨药物洗脱支架 [ Abstract J Objective To evaluate the effect of the combination of rotational atherectomy (队) with drug-eluting stent ( DES) on heavily calcified lesions. Methods 32 patients with severely calcified lesions were treated with RA followed by DES. The imrnediate success rate and the incidence rate of MACE during hospitalization were analyed. R，臼ults AII 由e lesions were ei由er type B2 or C heavily calcified 1esions under angiography.ηle burrs passed through the lesions successfully in all cases. AlI patients received DES after RA. The diameter stenosis rate of the lesions decreased from (89 .3:t 7.8 ) % to (8.2 士1.7) %, the imrnediate angiography success rate was 100%. The burr was 仕actured in coronary artery during prωedure， in I c部e (3 .1%) . 8 patien也 whose troponin 1 levels were elevated more 出an 3 tÏn1es 耻normal high lÏn1 it (NHL) , had non-Q wave myocardial infarction. One patient was dead due to hemorrhagic shock resulted 企om re住operitoneal hematoma. 24 hours after procedure. No coron缸y vasospasm , perforation , no-reflow , slow reflow occurred. No one needed emergent rcvascularization and CABG. Conclusion The combination of RA with DES was effective and safe in the trea田lent of coronary heavily calcified lesions , and may increase the success rate of the