药物洗脱球囊与药物洗脱支架治疗支架内再狭窄疗效比较

目的 对比药物洗脱球囊(DEB)和药物洗脱支架(DES)治疗冠状动脉疾病支架植入后支架内再狭窄(ISR)的安全性和有效性.方法 回顾性分析2012年1月至2014年12月收治的76例支架植入后ISR患者临床资料.根据治疗方法分为紫杉醇DEB组(n=32)和紫杉醇DES组(n=44).收集一般资料及冠状动脉造影特征,记录术后1年患者全因死亡、心源性死亡、心肌梗死、支架内血栓形成、靶病变血运重建、靶血管血运重建、主要心血管不良事件(MACE).结果 DEB组和DES组患者一般资料具有良好均衡性(P＞0.05).ISR发生在前降支较多(DEB组43.75％,DES组47.73％).两组ISR靶血管类型类似(P＞0.05).两组裸金属支架(BMS)和DES植入术后ISR类型、ISR病变类型、再狭窄支架特点差异均无统计学意义(P＞0.05).随访12个月显示,全因死亡、心源性死亡、心肌梗死、支架内血栓形成、靶血管血运重建、靶病变血运重建及MACE发生率差异均无统计学意义(P＞0.05).进一步分析无事件生存率,两组差异无统计学意义(P＞0.05).结论 DEB治疗BMS或DES植入术后ISR安全可行,疗效不低于DES治疗.

Paclitaxel-eluting balloon versus drug-eluting stent for in-stent restenosis: comparative study of curative effect

Objective To compare the safety and effectiveness of drug-eluting balloon (DEB) with paclitaxel and drug eluting stent (DES) in treating in-stent restenosis (ISR).Methods The clinical data of a total of 76 patients with ISR,who were admitted to authors' hospital to receive stem implantation during the period from January 2012 to September 2014,were retrospectively analyzed.According to the therapeutic means,the patients were divided into paclitaxel DEB group (n=32) and paclitaxel DES group (n=44).The general clinical information and coronary artery angiography findings were collected.The patients were followed up for one year;the all-cause mortality,cardiac death,myocardial infarction,in-stent thrombosis,target lesion revascularization,target vessel revascularization,and major adverse cardiac events were documented.Results No obvious difference in the general data of patients existed between group DEB and group DES (P＞0.05).The incidences of left anterior descending artery ISR in DEB group and in DES group were 43.75％ and 47.73％ respectively.The ISR target vessel types of the two groups were quite similar (P＞0.05).No statistically significant differences in ISR type,ISR lesion type and characteristics of in-stent restenosis existed between the two groups (P＞0.05).One-year following-up examinations indicated that no statistically significant differences in all-cause mortality,cardiac death,myocardial infarction,in-stent thrombosis,target lesion revascularization,target vessel revascularization,and major adverse cardiac events existed between the two groups (P＞0.05).Further analysis revealed that no significant difference in event-free survival existed between the two groups (P＞0.05).Conclusion For the treatment of ISR,the use of paclitaxel DEB is safe and feasible,its curative effect is not less than DES.