Clinical efficacy analysis of the treatment of chronic total occlusion with drug-coated balloon only
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摘要: 目的:观察单纯使用药物涂层球囊(DCB)治疗冠状动脉(冠脉)慢性完全闭塞性病变(CTO)的有效性和安全性。方法:回顾性分析郑州大学第一附属医院心内科2018年1月至2020年6月CTO病变单纯接受DCB治疗的患者45例,共计49处病变,在术后至少3个月患者均行冠脉造影复查。观察终点为靶血管病变处再狭窄、再闭塞和主要心血管不良事件,包括心源性死亡、心肌梗死和靶病变血运重建(TLR)。结果:45例患者共49处CTO病变在成功开通并进行充分预扩张的情况下单纯植入DCB治疗,其中有2例(4.4%)患者因DCB治疗后出现严重的冠脉夹层而进行了补救性支架植入治疗,47处病变成功植入DCB。随访时,晚期管腔丢失直径为(0.04±0.57) mm, 1处(2.1%)病变发生再闭塞,7处(14.9%)病变发生再狭窄。TLR率为6.7%(3/45),主要心血管不良事件发生率为6.7%(3/45),所有患者在随访期间均无心源性死亡、心肌梗死发生。结论:CTO病变开通后,在预扩张效果良好的情况下,单纯使用DCB治疗是一种可行且安全性良好的治疗方法。
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关键词:
- 药物涂层球囊 /
- 慢性完全闭塞性病变 /
- 经皮冠状动脉介入治疗
Abstract: Objective: To observe the effectiveness and safety of chronic total occlusion(CTO) of coronary artery treated with drug-coated balloon(DCB) only.Methods: A retrospective analysis was performed on 45 patients with 49 chronic coronary arterial occlusions who were simply treated with DCB, from January 2018 to June 2020 in the Department of Cardiology, the First Affiliated Hospital of Zhengzhou University. At least 3 months after the operation, all patients were followed up by coronary angiography. The end point was the restenosis and reocclusion of the target vessel lesion as well as major adverse cardiovascular events(MACE), including cardiac death, myocardial infarction(MI) and target lesion revascularization(TLR).Results: A total of 49 CTO lesions in 45 patients were simply treated with DCB if they were successful opened and fully predilated. The 2 patients(4.4%) underwent remedial stent implantation due to severe coronary dissection after DCB implantation, and 47 lesions were successfully treated with DCB. During follow-up, the late lumen loss was(0.04±0.57) mm, one(2.1%) lesion occurred re-occlusion, and seven(14.9%) lesions occurred restenosis. The TLR rate and the MACE rate was 6.7%(3/45) all. There was no cardiac death and MI during the follow-up.Conclusion: After the CTO lesion was opened and well predilated, DCB is a feasible and safe therapeutic strategy. -
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