球囊支撑导引导丝治疗冠状动脉完全闭塞性病变临床研究

目的观察以球囊支撑普通导引导丝(中等硬度3～4 g)行冠状动脉完全闭塞性病变的介入治疗的可行性、安全性和有效性。方法行冠状动脉造影检查诊断为冠状动脉完全闭塞性病变并行介入治疗(PCI)的患者38例,其中陈旧性心肌梗死19例,不稳定型心绞痛12例,稳定型心绞痛7例。比较单独使用导引导丝以及使用导引导丝未成功,以球囊支撑导引导丝治疗成功方法,分析成功病例与未成功病例临床特点。结果 38例患者29例(76%)获得成功。完全闭塞时间≤12个月者17例(58.6%)比3例(33.3%),>12个月为12例(41.4%)比6例(66.7%),闭塞端的形状(刀切状:20.7%比55.6%;桥侧支:13.8%比66.7%),闭塞段的长度≥15 mm的患者比例(37.9%比77.8%)差异均有统计学意义(P<0.05)。两组术中无死亡病例,术后住院期间无主要不良心脏事件(MACE)发生。结论以球囊支撑普通导引导丝行冠状动脉完全闭塞病变的介入治疗安全方便,成功率较高。

Efficacy and safety of percutaneous coronary intervention by using guidewire depended on balloon method for total occlusions

Objective To investigate the efficacy and safety of percutaneous coronary intervention(PCI) by using guidewire depended on a balloon for total occlusions.Methods From March 2009 to June 2010,38 patients(46 vessels) with total occlusions who underwent PCI were enrolled in this study.Patients were assigned to group 1(guidewire only) or group 2(guidewire depended on balloon).Clinical data including success of PCI,perioperative complication and the incidence of major adverse cardiac events(MACE) were collected ...