【摘要】 目的观察药物涂层球囊(drug coated balloon,DCB)在前降支近端的支架内再狭窄复杂冠状动脉病变中应用的有效性和安全性。方法选择8例冠状动脉粥样硬化性心脏病(冠心病)患者为研究对象,其中急性冠脉综合征(ACS)7例,稳定型心绞痛1例。所有患者均既往在前降支(LAD)近端植入支架,此次病变为支架内再狭窄>70%,累及主干和回旋支(70%>狭窄程度>50%),血管直径介于2.5 mm至3.5 mm的血管。应用DCB仅处理前降支再狭窄病变,观察手术成功率、并发症和半年随访主要心血管事件发生率。结果所有患者都成功应用DCB处理病变,成功率为100%。最终影像结果显示靶血管心肌梗死溶栓试验(thrombolysis inmyocardial infarction,TIMI)血流均为3级,所有患者术中及术后均无并发症发生,随访半年所有患者无死亡,无心肌梗死,无再次血运重建情况发生。结论 DCB对前降支近端的支架内再狭窄累及主干和回旋支复杂病变的治疗不仅缩短了手术时间,提高手术的安全性,并且并发症少,近期疗效满意。更多还原

【Abstract】 Objectives To evaluate clinical efficacy and safety of drug coated balloon(DCB)application in in-stent restenosis of left anterior descending complex artery lesion in coronary during percutaneous coronary intervention(PCI) procedure.Methods There were totally 8 patients with coronary heart diseases,including 7 cases of acute coronary syndrome(ACS) and 1 case of stable angina pectoris.All the patients had stents implanting histories in left anterior descending(coronary artery)(LAD)proximal segment.And now LAD stent occurred in-stent restenosis(>70%)extending to distal segment of left main artery and proximal segment of left circumflex coronary(70%>lesion stenosis percentage>50%).Vessel diameter was between 2.5 mm to 3.5 mm.Only LAD in-stent restenosis lesion was treated by DCB in all cases.PCI success rate,incidence of complication and six months follow-up result were observed.Results All cases finally finished PCI process using DCB with success rate was 100%.The final imaging results indicated that thrombolysis in myocardial infarction(TIMI)blood flow was grade 3 in target vessel.No visible dissection was recorded and no patients needed revascularization,and no acute myocardial infarction and death occurred.During 6 months follow-up,there was no major adverse cardiac event(MACE)occurred.Conclusions Application of DCB for in-stent restenosis lesion in LAD proximal segment with left main artery or left circumflex coronary stenosis complex lesion can shorten the procedural duration and ensure overall procedural success without complication occurred.更多还原