Cutting-balloon angioplasty before drug-eluting stent implantation for the treatment of severely calcified coronary lesions |
| |
Authors: | Zhe TANG Jing BAI Shao-Ping SU Yu WANG Mo-Han LIU Qi-Cai BAI Jin-Wen TIAN Qiao XUE Lei GAO Chun-Xiu AN and Xiao-Juan LIU |
| |
Institution: | Institution of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China;Institution of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China;Outpatient Division, Chinese PLA General Hospital, Beijing, 100853, China;Institution of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China;Institution of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China;Department of Cardiology, Chinese PLA General Hospital, Beijing, 100853, China;Institution of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China;Institution of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China;Institution of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China;Institution of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China;Institution of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China |
| |
Abstract: | BackgroundSeverely calcified coronary lesions respond poorly to balloon angioplasty, resulting in incomplete and asymmetrical stent expansion. Therefore, adequate plaque modification prior to drug-eluting stent (DES) implantation is the key for calcified lesion treatment. This study was to evaluate the safety and efficacy of cutting balloon angioplasty for severely calcified coronary lesions.MethodsNinety-two consecutive patients with severely calcified lesions (defined as calcium arc ≥ 180° calcium length ratio ≥ 0.5) treated with balloon dilatation before DES implantation were randomly divided into two groups based on the balloon type: 45 patients in the conventional balloon angioplasty (BA) group and 47 patients in the cutting balloon angioplasty (CB) group. Seven cases in BA group did not satisfactorily achieve dilatation and were transferred into the CB group. Intravascular ultrasound (IVUS) was performed before balloon dilatation and after stent implantation to obtain qualitative and quantitative lesion characteristics and evaluate the stent, including minimum lumen cross-sectional area (CSA), calcified arc and length, minimum stent CSA, stent apposition, stent symmetry, stent expansion, vessel dissection, and branch vessel jail. In-hospital, 1-month, and 6-month major adverse cardiac events (MACE) were reported.ResultsThere were no statistical differences in clinical characteristics between the two groups, including calcium arc (222.2° ± 22.2° vs. 235.0° ± 22.1°, P = 0.570), calcium length ratio (0.67 ± 0.06 vs. 0.77 ± 0.05, P = 0.130), and minimum lumen CSA before PCI (2.59 ± 0.08 mm2
vs. 2.52 ± 0.08 mm2, P = 0.550). After stent implantation, the final minimum stent CSA (6.26 ± 0.40 mm2
vs. 5.03 ± 0.33 mm2; P = 0.031) and acute lumen gain (3.74 ± 0.38 mm2
vs. 2.44 ± 0.29 mm2, P = 0.015) were significantly larger in the CB group than that of the BA group. There were not statistically differences in stent expansion, stent symmetry, incomplete stent apposition, vessel dissection and branch vessel jail between two groups. The 30-day and 6-month MACE rates were also not different.ConclusionsCutting balloon angioplasty before DES implantation in severely calcified lesions appears to be more efficacies including significantly larger final stent CSA and larger acute lumen gain, without increasing complications during operations and the MACE rate in 6-month. |
| |
Keywords: | Cutting balloon angioplasty Calcified lesion Intravascular ultrasound Percutaneous coronary intervention |
本文献已被 维普 等数据库收录! |
| 点击此处可从《老年心脏病学杂志(英文版)》浏览原始摘要信息 |
| 点击此处可从《老年心脏病学杂志(英文版)》下载免费的PDF全文 |
|