冠心病合并缺血性脑血管病患者一站式完成心脑血管介入治疗的可行性研究

目的探索对冠心病合并缺血性脑血管病患者行一站式介入治疗的可行性。方法对首都医科大学附属北京友谊医院通州院区2019年2月至2020年1月收治的符合条件的冠心病合并缺血性脑血管病患者进行一站式心脑血管造影检查,然后经心血管和脑血管介入团队共同讨论决定介入治疗策略和方案,完成介入治疗。分析所有患者的临床资料、手术资料、随访结果。主要终点是院内和随访期内主要不良心脑血管事件(包括死亡、心肌梗死和卒中的复合事件)发生率。次要终点是主要终点中的任何一个(心肌梗死、卒中、死亡)及对比剂肾病、再入院。结果共入组30例患者,全部行一站式造影检查。其中,19例行经皮冠状动脉介入治疗,18例行脑血管介入治疗,包括13例同时行经皮冠状动脉和脑血管介入治疗者。共计一站式介入手术41次,其中一站式完成冠状动脉和脑血管介入治疗13次。所有患者治疗手术成功率为100%,住院期间和随访1~12个月内无主要不良心脑血管事件发生。2例患者再入院,包括1例股动脉并发症和1例肺部感染,均经治疗好转出院。结论一站式完成心脑血管介入治疗的模式可行,有较好的有效性和安全性,在有条件的医院可以推广开展。

Study on the feasibility of one-stop cardio-cerebrovascular interventional therapy for patients with coronary heart disease complicated with ischemic cerebrovascular disease

Objective To investigate the feasibility of one-stop interventional therapy for patients with coronary heart disease complicated with ischemic cerebrovascular disease.Methods The eligible patients with coronary heart disease complicated with ischemic cerebrovascular disease admitted to Beijing Friendship Hospital,Capital Medical University from February 2019 to January 2020 received the coronary and cervical-cerebral artery angiography in same procedure,and then the patients finished interventional therapy after cardiovascular and cerebrovascular interventional teams discussing and deciding the interventional treatment strategy.The clinical data,surgical data and follow-up results of all patients were analyzed.The primary endpoints were the incidence of major cardiac and cerebrovascular events in the time of hospitalization and follow-up,including death,myocardial infarction,or stroke occurring,and the secondary endpoints were any one of the primary endpoints(death,myocardial infarction,stroke),contrast induced nephropathy,and readmission.Results A total of 30 patients were enrolled and underwent one-stop angiography,including 19 cases of percutaneous coronary intervention,18 cases of cerebral artery stenting,and 13 cases of simultaneous percutaneous coronary intervention and cerebral artery stenting.A total of 41 one-stop interventional surgeries were performed,among which,coronary artery and cerebrovascular interventional treatment in one-stop were completed for 13 times.All the simultaneous or staged intervention procedures for coronary and cerebral artery were successful(100%).There was no any major cardiac and cerebrovascular event occurred in-hospital and follow-up of 7 months.Two patients were readmitted,including one with surgical resection and repair because of the complication of pseudoaneurysm,and one for pneumonia,both were successfully recovered and discharged.Conclusions It is safe and eff ective to perform simultaneous intervention treatment for coronary and cerebral artery for the patient with coronary heart disease and ischemic cerebrovascular disease,which could be widely used in hospitals with good conditions.