经桡动脉的旋磨治疗26例冠心病严重钙化

【目的】探讨经桡动脉冠状动脉旋磨术治疗冠状动脉钙化病变的安全性及有效性。【方法】回顾性分析26例经桡动脉冠状动脉旋磨术的冠心病患者的临床资料、旋磨参数、手术结果和随访术后6个月主要不良心血管事件(包括死亡、心肌梗死、靶病变血运重建)。【结果】26例患者选择6F/7F指引导管的比例分别是14/12例,其中25例患者行单只血管的旋磨治疗,1例患者同时行前降支和回旋支旋磨治疗,管腔狭窄由术前85%±11%减少至52%±8%,全部患者手术成功,术中无死亡、心肌梗死和冠脉穿孔等并发症发生,术后桡动脉闭塞发生率30.7%,6个月随访总不良心血管事件11.5%。【结论】经桡动脉旋磨治疗手术成功率高,不良心血管事件发生率低,临床安全、有效,可以推广。

Clinical application of rotational atherectomy in coronary artery calcification lesions in 26 patients

[Objective] To investigate the safety and efficacy of trans radial artery coronary rotational athemctomy in the treatment of coronary artery calcification lesions. [Methods] Clinical data of 26 patients diagnosed as coronary artery atherosclerosis treated with coronary rotational atherectomy were analyzed. Procedural success rate and clinical effect of postoperative visiting and main adverse cardiovascular events（including cardiac death, myocardial infarction and target lesion revascularization）were recorded and analyzed. [Results] 6F guiding catheter was selected in 14 patients, and 12 patients were selected 7F guiding catheter. 25 patients were only treated one vessel, and 1 patient was treated two vessels simutaneously, whose mean proportion of stenosis was decreased from 85 % ＋ 11% to 52% ＋ 8 %. Procedural success was achieved in all patietns. No main adverse cardiovascular events （including cardiac death, Q wave myocardial infarction and emergency coronary surgery） occurred during operation.The ratio of radial artery occlusion was 30.5% after operation. Total main adverse cardiovascular events after six month from operation were 11.5%. [Conclusions] Coronary rotational atherectomy from radial artery is effective and safe in the treatment of coronmy artery calcification lesions and it can be generalizationaly used.