药物洗脱球囊在冠状动脉特殊病变介入治疗中的应用分析

目的分析药物洗脱球囊（DEB）在再狭窄病变、支架内闭塞病变、分叉病变及小血管病变中的应用情况。方法根据冠状动脉造影结果选择不同型号的DEB,严格按照DEB使用要求进行操作。结果 DEB在支架内再狭窄病变中应用26例（27处病变）,使用28个DEB,其中左主干（LM）1个、左前降支（LAD）12个、右冠状动脉（RCA）12个、回旋支（LCX）1个、钝缘支（OM）2个,出现1例冠状动脉夹层,给予裸金属支架置入;DEB在分叉病变中应用27例（28处病变）,使用28个DEB,其中LM至LCX开口6个、LM至LAD开口1个、LAD与第一对角支（D1）开口17个、LCX至OM 2个、RCA至左心室后支（PL）2个;DEB在小血管病变中应用13例（13处病变）,使用13个DEB,其中LCX 6个、LAD 3个、D1 2个、OM 1个、PL 1个;DEB在支架内闭塞病变中应用10例（10处病变）,使用12个DEB,其中LAD 8个、LCX 2个、OM 1个、中间支1个。术中及术后未见并发症发生,随访至今未发生主要不良心血管事件（MACE）。结论 DEB在再狭窄病变、支架内闭塞病变、分叉病变及小血管病变介入治疗过程中是安全的。

Analysis of drug eluting balloon in treating special coronary lesions during percutaneous coronary intervention

Objective To study the application of drug eluting balloon（ DEB） in treatment of stent restenosis lesions,occlusion lesions,bifurcation lesions and small coronary arteries in a single center.Methods According to coronary angiography results,we chose DEBs with different types,and carried on the procedures strictly according with the requirements. Results 1. We used 28 DEBs in 26 cases of stent restenosis（ 27 lesions）,included 1 in LM,12 in LAD,12 in RCA,1 in LCX and 2 in OM. Coronary artery dissection appeared in LAD,then we implanted BMS in LAD. 2. We used 28 DEBs in 27 cases of bifurcation lesions（ 28 lesions）,included 6 in LM and LCX opening,1 in LM and LAD opening,17 in LAD and D1 opening,2 in LCX and OM opening,2 in RCA and PL opening. 3. We used 13 DEBs in 13 cases of small coronary arteries（ 13 lesions）,included 6 in LCX,13 in LAD,2 in D1,1 in OM and 1 in PL. 4. We used12 DEBs in 10 cases of occlusion lesions（ 10 lesions）,included 8 in LAD,2 in LCX 1 in OM and 1 in intermediate branch. No complications occurred during and after operation. There were no MACE events in the follow-up. Conclusions The application of DEB in treating stent restenosis lesions,occlusion lesions,bifurcation lesions and small coronary arteries is safe.