支架影像增强显影技术及其对球囊后扩张的指导作用

目的:探讨支架影像增强显影技术(StentBoost,SB)增强冠状动脉(冠脉)支架显影以及对球囊后扩张的指导作用。方法:收集2009-03至2010-07经皮冠脉介入治疗(PCI)术后在SB指导下给予球囊后扩张的184例患者资料,平均年龄(64.5±10.9)岁(42～83岁),对其后扩张前后SB测量数据进行比较。其中52例(28.26%)患者给予血管内超声(IVUS)检查,并分别对冠脉狭窄程度定量分析(QCA)、IVUS和SB检测数据进行相关性分析。结果:后扩张后较后扩张前支架内最小直径(2.72±0.35)mm vs.(2.42±0.39)mm]、支架内最大直径(3.26±0.37)mm vs.(3.09±0.38)mm]及支架内平均直径(2.99±0.36)mm vs.(2.76±0.43)mm]均明显增大,支架偏心指数(0.17±0.04 vs.0.22±0.06)明显减小,差异均有统计学意义(P<0.001)。支架内最小直径IVUS与SB的相关性r=0.979,P<0.0001;冠脉狭窄程度定量分析与SB的相关性r=0.973,P<0.0001;QCA与IVUS的相关性r=0.964,P<0.0001。结论:SB与IVUS具有良好的相关性,且在评价支架置入效果以及指导高压球囊后扩张方面具有临床实用价值。

Effect of Imaging Processing Technique of StentBoost for Guiding the Post Dilatation in Patients With Percutaneous Coronary Intervention

Objective:To study the effect of motion-corrected fluoroscopic imaging(StentBoost) for enhancing the coronary stent visualization and for guiding the stent post dilatation. Methods:We retrospectively summarized 184 patients with percutaneous coronary intervention(PCI) from March 2009 to July 2010.The patients were(64.5±10.9)years of age.52(28.26%)patients received intravascular ultrasound(IVUS).We analyzed the related information of quantitative coronary angiography(QCA),IVUS and StentBoost enhanced post dilatation. Results:After post dilatation,the minimum stent diameter(2.72±0.35)mm vs.(2.42±0.39) mm,the maximum stent diameter(3.26±0.37)mm vs.(3.09±0.38) mm,the average stent diameter(2.99±0.36)mm vs.(2.76±0.43) mm were enlarged and the stent eccentricity index was decreased(0.17±0.04 vs.0.22±0.06) than they were before,P<0.001 respectively.The correlation of minimum stent diameter between IVUS and StentBoost:r=0.979;P< 0.0001,between QCA and StentBoost:r=0.973;P< 0.0001,and between QCA and IVUS:r=0.964,P< 0.0001. Conclusion:There is good correlation between StentBoost and IVUS,it has the practical value for evaluating PCI and guiding the high pressure balloon post inflation in clinical practice.