不同类型冠状动脉斑块支架植入术的比较

目的 回顾性分析冠状动脉支架术前已行64层螺旋CT冠状动脉成像的病例,比较不同类型冠状动脉斑块支架术的差异.方法 选择2007年至2009年支架术前已行64层螺旋CT检查的患者86例,共植入支架137处.依据冠状动脉斑块平均CT值将冠状动脉斑块分为非钙化斑块组和钙化斑块组.比较两组的临床特征、预扩张球囊规格、预扩张球囊充盈压力、支架规格和支架释放压力.结果 与非钙化斑块组相比,钙化斑块组年龄相对较高,低密度脂蛋白更低,单支病变较少.两组的预扩张球囊和支架规格无明显差异.钙化斑块组预扩张球囊充盈压力(898.93±159.67 kPa)明显高于非钙化斑块组(810.22±112.61 kPa,P<0.01).钙化斑块组支架释放压力(1 403.90±273.12 kPa)明显高于非钙化斑块组(1 243.79±254.12 kPa,P<0.01).结论 与非钙化斑块相比,钙化斑块对预扩张和支架成形有较大阻力,硬度较高,术前识别斑块类型对支架术有一定意义.

Comparison of the Coronary Stent Implantation Between Different Types of Coronary Plaques

Aim To compare the coronary stent implantation between different types of coronary plaque by retrospectively investigating patients who received 64-slice spiral computed tomography coronary angiography before coronary stent implantation. Methods 86 patients who received 64-slice spiral computed tomography angiography before stent implantation from 2007 to 2009 were selected. 137 stents were implanted. Those coronary atherosclerotic plaques were divided into calcified plaque group and noncalcified plaque group based on average computed tomography value of plaque. Clinical character,ballon size,balloon predilation pressure,stent size,stent release pressure in two groups were compared. Results The age of patients in noncalcified plaque group was relatively younger than that in calcified plaque group. The low-density lipoprotein in noncalcified plaque group was higher than that in calcified plaque group. The proportion of 1-vessel disease in noncalcified plaque group was higher than that in calcified plaque group. The size of ballon and stent were similar in those two groups. The balloon predilation pressure in calcified plaque group was higher than that in noncalcified plaque group(898.93±159.67 kPa vs 810.22±112.61 kPa,P><0.01). Stent release pressure in calcified plaque group was higher than that in noncalcified plaque group(1 403.90±273.12 kPa vs 1 243.79±254.12 kPa,P><0.01). Conclusion Compared with noncalcified plaque,calcified plaque was stiffer,and had higher resistance to balloon predilation and stent angioplasty. Identifying the type of plaque before coronary stent implantation was significant.