Comparison of floating wire and single wire techniques in right coronary artery ostial lesions
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摘要: 目的：比较漂浮导丝技术与传统单导丝技术进行右侧冠状动脉（冠脉）开口病变介入治疗的有效性和安全性。方法：回顾性分析149例右侧冠脉开口严重狭窄患者，98例患者采用单导丝技术进行介入治疗，另外51患者采用漂浮导丝技术。右侧冠脉开口病变支架完全准确覆盖成功率作为研究的第一终点，同时比较两组PCI治疗时对比剂的用量、透视时间、支架用量及支架长度等参数。此外，进行两组患者术后1年无心脏不良事件生存率的对照分析。结果：两组基础临床和病变特征及技术参数无明显差异。漂浮导丝技术组准确支架覆盖的成功率明显高于单导丝技术组[96.1%∶84.7%，P<0.05]；且其对比剂用量、PCI耗时，支架长度及支架数量均少于单导丝技术组；生存分析示两组无不良心血管事件生存率无显著性差异（P>0.05）。结论：漂浮导丝技术是改善右侧冠脉开口病变操作成功率的有效方法，可在临床推广应用。Abstract: Objective: To compare the effectiveness and safety of floating wire technique with single wire technique in percutaneous coronary intervention (PCI) procedure in right coronary ostial lesions.Method: One hundred and forty nine patients with critical right coronary aorto-ostial lesion were retrospectively analyzed in this study.The floating wire technique was performed on 51 patients, and the single wire technique was performed on 98 patients.Successful rates of optimal stent position and other procedural properties of two groups were compared with each other.Additionally, clinic outcomes during 1-year clinical follow-up were compared between the two groups.Result: There was no significant difference of baseline clinic characteristics and lesion properties between two groups.The successful rates of optimal stent position in floating technique group was higher than single wire technique group[96.1% vs.84.7%, P<0.05].Moreover, in the floating wire technique group, the mean stent length, number of stents, mean contrast volume, and mean fluoroscopy time were significantly lower than in the single wire group.However, during 1-year clinic follow up, there was no significant difference in term of the incidence of major adverse cardiovascular events between two groups.Conclusion: In right coronary ostial lesions PCI procedures, the floating wire technique is more effective and safe compared with the single wire technique.
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