冠状动脉介入术中支架影像增强显影技术与血管内超声对照研究

目的探讨支架增强显影技术(stentboost,SB)在评价支架植入效果和指导支架内球囊后扩张与血管内超声(intravascular ultrasound,IVUS)的相关性。方法 26例患者在支架植入、支架内球囊后扩张时,完成了冠状动脉造影定量分析(quantative coronary angiography,QCA)、SB技术、IVUS检查,植入支架35枚。分别通过QCA、SB、IVUS获取支架植入、支架内球囊后扩张完成时支架直径,计算支架偏心指数;各项检查所测支架植入、支架内球囊后扩张完成时支架直径和支架偏心指数的自身对照,检查之间所测数据进行相关性分析。结果 QCA、SB、IVUS测量的支架内球囊后扩张完成时支架直径均较支架植入时明显增加,支架偏心指数[(最大支架直径-最小支架直径)/最大血管直径]降低。SB与IVUS测量的支架植入时、支架内球囊后扩张完成时的支架平均直径具有最好的相关性(r=0.982,P0.01;r=0.985,P0.01);而且QCA与IVUS也具有较好的相关性(r=0.975,P0.01;r=0.978,P0.01);QCA与SB也明显相关(r=0.972,P0.01;r=0.976,P0.01)。结论支架内球囊后扩张完成时支架偏心指数较支架植入时更低,与QCA相比,SB与IVUS测量的支架植入时、支架内球囊后扩张完成时的支架平均直径有更好的相关性。

Comparison of StentBoost with intravascular ultrasound in percutaneous coronary intervention

Objective To discuss the correlation between StentBoost（SB）and intravascular ultrasound（IVUS）for assessing stent implantation and guiding the stent post dilatation.Methods Twenty-six patients were analyzed using quantitative coronary angiography（QCA）,IVUS,and SB,35stents were implanted.Twenty-six patients（35stents）were performed with postdilatation.Stent diameter poststenting and postdilation were measured by QCA,by IVUS by SB respectively;the ratio（maximum stent diameter[MaxLD]-minimum stent diameter[MaxLD]/MaxLD were calculated respectively.Stent diameter were analyzed in poststenting and postdilation check;correlations of three chicks were analyzed.Results The minimum diameter,maximum diameter and average diameter of postdilatation obtained by QCA,IVUS,SB were significantly larger than those of poststenting,and the ratio（maximum stent diameter[MaxLD]-minimum stent diameter[MaxLD]/MaxLD of postdilatation was smaller.Correlations of average diameter were the best between IVUS and SB（r=0.982,P0.01;r=0.985,P〈0.01）,and those were also better between QCA and SB（r=0.975,P〈 0.01;r=0.978,P〈0.01）,futher more those by QCA and IVUS were significant（r=0.972,P 0.01;r=0.976,P〈0.01）in stent implantation and post-dilatation.Conclusion The stent eccentricity index becomes small after postdilatation in every group;SB has superior correlations for stent directers measured by IVUS when compared with QCA of stent implantation and postdilatation.