HSRA联合PTCA或支架成形术治疗老年钙化性冠状动脉狭窄

目的:探讨高速冠状动脉旋磨术(HSRA)联合经皮冠状动脉腔内血管成形术(PTCA)或支架置入术对治疗老年冠心病患者钙化性冠状动脉狭窄近期和远期效果。方法:对30例老年冠心病患者经冠状动脉造影诊断为钙化性狭窄的31处靶血管行高速冠状动脉旋磨术,并行补充性PTCA或支架置入术,观察近期疗效、并发症发生率、远期随访结果。结果:由术前狭窄(83.6±5.6)％减至术后残余狭窄(7.0±9.4)％,血管造影成功率100％,操作成功率96.7％,急性期无死亡、Q波心肌梗死、急诊冠脉搭桥(CABG),1例无Q波心肌梗死,随访期内1例心肌缺血症状复发,心源性死亡1例,再次血管重建2例,无CABG病例。结论:高速冠状动脉旋磨术联合PTCA或支架置入术治疗老年患者钙化性冠状动脉狭窄安全可行,成功率高,并发症少,远期效果好。

The treatment of calcified coronary stenosis in elderly patients of coronary artery disease with high speed coronary rotational atherectomy adjunt ballon angioplasty or coronary stenting

Objective: To approach the short and long period results of high speed rotational atherectomy (HSRA) adjunt ballon angio-plasty or coronary stenting in calcified coronary stenosis of elderly patients with coronary artery disease. Methods: HSRA adjunct percutaneous transluminal coronary angioplasty(PTCA) or coronary stenting was performed in 31 calcified lesions identified coronary arigiog-raphy ,short or long period results and complications was observed. Results:The mean diameter stenosis before angioplasty was (83.6±5.6)% ,residual stenosis following intervention was (7. 0±9. 4)% , so the success rate of coronary angiography and operation was 100% and 96.7%. There was no death,Q-wave MI or CABG ocurred and non-Q-wave MI happened in one case during acute period. Angina (1 case) , cardiogenic death (1 case) and revascularization (2 cases) were recurrent in fllow-up period. No CABG was seen. Conclusion: HSRA adjunct PTCA or coronary stenting is an effective, safe and feasible method to treat calcified coronary stenosis of elderly patients according to short or long period results.