冲击波血管内碎石术治疗冠状动脉钙化病变有效性和安全性分析
Shockwave intravascular lithotripsy for the treatment of coronary artery calcification lesions:analysis of its efficacy and safety
张紫微 1白洁 1郑甲林 1唐炯 1杨帮国 1蔡文峰 1齐峰1
作者信息
- 1. 650102 云南昆明 云南省阜外心血管病医院冠心病中心
- 折叠
摘要
目的 探讨冲击波球囊血管内碎石术(IVL)在冠状动脉钙化病变中应用的安全性和有效性.方法 研究对象为2022年8月至2023年4月在云南省阜外心血管病医院接受介入治疗的50例中重度冠状动脉钙化病变患者,其中各25例分别采用Shockwave球囊IVL、临床常规介入方法治疗.血管内超声导引手术操作,评估钙化病变特征及术后支架膨胀率.观察记录围手术期并发症发生率.结果 IVL治疗组术后患者最狭窄处支架膨胀率显著高于非IVL治疗组[(82.6±8.2)％比(76.4±11.2)％,P=0.030],手术时间更短[(78.6±30.8)min比(102.9±37.5)min,P=0.016],发生非Q波性心肌梗死患者更少(5例比12例,P=0.037),均未发生慢血流、无复流、冠状动脉穿孔、急性支架内血栓等并发症.结论 冲击波球囊IVL治疗中重度冠状动脉钙化病变安全有效,可显著改善支架膨胀率,降低并发症发生率.
Abstract
Objective To discuss the efficacy and safety of shockwave balloon intravascular lithotripsy(IVL)in treating coronary artery calcification lesions.Methods A total of 50 patients with moderate to severe coronary artery calcification lesions,who were admitted to the Yunnan Provincial Fuwai Cardiovascular Disease Hospital of China to receive interventional treatment between August 2022 and April 2023,were enrolled in this study.Shockwave balloon IVL was carried out in 25 patients(IVL group)and routine percutaneous coronary intervention(PCI)was employed in the other 25 patients(non-IVL group).Intravascular ultrasound(IVUS)was used to guide the surgical procedures,to assess the calcified lesion's characteristics,and to evaluate the postoperative stent expansion ratio.The incidence of perioperative complications was calculated.Results Compared with non-IVL group,in IVL group the postoperative stent expansion ratio at the narrowest point was significantly higher[(82.6±8.2)％versus(76.4±11.2)％,P=0.030],the time spent for operation was obviously shorter[(78.6±30.8)min versus(102.9±37.5)min,P=0.016],and the incidence of non-Q-wave myocardial infarction was remarkably lower(5 cases versus 12 cases,P=0.037).No complications such as slow blood flow,absence of reflow,coronary artery perforation,or acute in-stent thrombosis occurred in IVL group.Conclusion For the treatment of moderate to severe coronary artery calcification lesions,shockwave IVL is clinically safe and effective,it can significantly improve the stent expansion ratio and reduce the incidence of complications.(J Intervent Radiol,2024,33:363-367)
关键词
钙化病变/冲击波球囊/血管内碎石术/经皮冠状动脉介入治疗Key words
calcification lesion/shockwave balloon/intravascular lithotripsy/percutaneous coronary intervention引用本文复制引用
基金项目
云南省科技重大专项(202102AA310002)
云南省科技厅-昆明医科大学联合专项(81170250)
出版年
2024
NETL
NSTL
万方数据