冠脉旋磨术在冠状动脉钙化病变患者PCI治疗中的应用价值

目的:研究冠脉旋磨术(CRA)在冠状动脉钙化(CAC)病变患者经皮冠状动脉介入(PCI)治疗中的应用价值。方法:2016年6月~2016年12月于我院治疗,且需行PCI治疗的CAC病变患者104例被随机分为旋磨治疗组(52例,接受CRA)和球囊扩张组(52例,接受球囊扩张术),比较两组介入治疗指标、术中并发症发生率及随访1年内主要心血管不良事件(MACE)发生率。结果:两组术前最小管腔直径无显著差异(P=0.304)。与球囊扩张组比较,旋磨治疗组手术时间(96.29±7.15)min比(72.96±5.76)min]、对比剂用量(113.25±14.54)ml比(83.27±13.18)ml]、放射线暴露时间(12.74±1.58)min比(9.07±1.26)min]、术中并发症发生率(26.92%比5.77%)显著降低,支架置入数量(1.75±0.28)枚比(2.27±0.35)枚]、术后最小管腔直径(3.15±0.53)mm比(4.31±0.86)mm]、病变残余狭窄<10%率(65.38%比94.23%)、手术即刻成功率(76.92%比98.08%)均显著升高(P均<0.01)。随访期间,旋磨治疗组MACE发生率显著低于球囊扩张组(13.46%比38.46%),P=0.004。结论:CRA能显著提高CAC病变患者PCI治疗手术成功率,降低术中并发症发生率,改善患者预后。

Application value of coronary rotational atherectomy in patients with coronary artery calcification undergoing PCI

Objective:To study application value of coronary rotational atherectomy(CRA)in patients with coronary artery calcification(CAC)undergoing percutaneous coronary intervention(PCI).Methods:A total of 104 CAC patients who needed PCI and were treated in our hospital from Jun 2016 to Dec 2016 were randomly divided into CRA group(n=52,received CRA)and balloon dilation group(n=52,received balloon dilation).Interventional therapy indexes,incidence rates of intraoperative complications and major adverse cardiovascular events(MACE)within one-year follow-up were compared between two groups.Results:There was no significant difference in preoperative minimum lumen diameter between two groups(P=0.304).Compared with balloon dilation group,there were significant reductions in operation time(96.29±7.15)min vs.(72.96±5.76)min],dose of contrast agent(113.25±14.54)ml vs.(83.27±13.18)ml],radiation exposure time(12.74±1.58)min vs.(9.07±1.26)min]and incidence rate of intraoperative complications(26.92%vs.5.77%),and significant rise in number of implanted stents(1.75±0.28)vs.(2.27±0.35)],postoperative minimum lumen diameter(3.15±0.53)mm vs.(4.31±0.86)mm],percentage of residual stenosis<10%(65.38%vs.94.23%)and operative immediate success rate(76.92%vs.98.08%)in CRA group(P<0.01 all).During follow-up,incidence rate of MACE in CRA group was significantly lower than that of balloon dilation group(13.46%vs.38.46%,P=0.004).Conclusion:CRA can significantly increase the operative success rate of PCI,reduce incidence rate of intraoperative complications and improve prognosis in CAC patients.