血管内超声在冠状动脉临界病变中的应用

目的评价血管内超声(IVUS)在冠状动脉临界病变中的应用价值和安全性。方法对经选择性冠状动脉造影(CAG)提示冠状动脉临界病变的50例患者的56处病变进行IVUS检查,分析粥样硬化斑块性质及其狭窄程度。结果56处病变中,脂质斑块为41处(73.2%),大部分可见薄的纤维帽,偏心斑块47处(83.9%),向心斑块6处(10.7%),3处仅轻度内膜增生。面积狭窄百分率(58%±14%)。对IVUS示面积狭窄≥50%的37处、<50%的7处(78.6%)且有典型临床症状的病变行进一步介入治疗。1例患者在IVUS检查过程中出现冠状动脉痉挛现象,经处理后不良反应立即消失。所有患者随访6个月以上,未出现严重心脏缺血事件。结论IVUS能进一步明确冠状动脉临界病变的性质、狭窄程度和指导下一步的治疗,安全性高。

INTRAVASCULAR ULTRASOUND APPLICATION FOR INTERMEDIATE CORONARY STENOSES

Objective To evaluate the value and safety of intravascular ultrasound (IVUS) in intermediate coronary stenosis. Method Fifty-six coronary artery segments with intermediate stenoses found by CAG in 50 patients were measured by IVUS. The characteristics of the atherosclerosis plaques were analyzed and stenosis rate was calculated. Result Among 56 lesions, there were 41(73.2%) soft plaque. Thin fibrous caps could be observed in most of the soft plaques, there were 47(83.9 %) eccentric plaques and 6(10.7%) concentric plaques.3 lesions had mild intimal proliferation. Area stenosis percentage was (5±14) % on lesion site. Further interventional treatment was performed in 37 lesions with area stenosis percentage≥50% and 7 lesion with area stenosis percentage <50% (78.6%) with typical clinical symptom. Transient coronary spasms were found separately in one patient during the examination of IVUS, and were disappeared rapidly by approximate treatment. During the follow up period of more than six months, no severe heart ischemic events occurred. Conclusion The characteristics and stenosis rate of intermediate coronary stenosis can be further clarified, and further treatment can be determined by IVUS, IVUS can be used safely.