Safety and effectiveness of Excimer laser coronary artery ablation in the treatment of complex coronary artery lesions
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摘要: 目的 探讨准分子激光冠状动脉消融术(excimer-laser coronary angioplasty，ELCA)在治疗冠状动脉复杂病变中的有效性和安全性。方法 纳入2023年2月21日一2023年5月4日武汉亚洲心脏病医院心内科使用ELCA治疗的冠状动脉复杂病变患者45例。观察ELCA手术成功率及相关并发症、术后1个月和1年随访期内发生的主要不良心血管事件(MACE)。结果 45例患者包括球囊难以通过的钙化病变(27例)、支架内狭窄(12例)、慢性闭塞性病变(2例)、桥血管病变(4例)。并发症中有4例患者出现慢血流、无复流，其中1例患者在发生慢血流、无复流后出现心脏骤停。ELCA手术成功率为97.78%。1个月和1年随访时，分别发生MACE事件2例和3例。结论 ELCA对于治疗复杂冠状动脉病变有良好的效果，总体安全性良好，但存在慢血流、无复流及心脏骤停风险。
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关键词:
- 激光消融术 /
- 复杂冠状动脉病变 /
- 经皮冠状动脉介入治疗 /
- 有效性 /
- 安全性
Abstract: Objective To explore the effectiveness and safety of ELCA in the treatment of complex coronary artery lesions.Methods The 45 patients with complex coronary artery lesions treated with ELCA in the Wuhan Asian Heart Hospital from February 21, 2023 to May 4, 2023 were included. We observed the success rate and related complications of ELCA, as well as the occurrence of MACE during the 1-month and 1-year follow-up periods after PCI.Results The 45 patients included calcified lesions that are difficult for balloons to pass through(27 cases), stent stenosis(12 cases), CTO lesions(2 cases), and Saphenous vein graft disease(4 cases). Complications Four patients experienced slow blood flow and no reflow, with one patient experiencing cardiac arrest after experiencing slow blood flow and no reflow. The success rate of ELCA was 97.78%. At the 1-month and 1-year follow-up, there were 2 and 3 MACE events, respectively. Conclusion ELCA has good efficacy and safety in the treatment of complex coronary artery lesions, but there are risks of slow blood flow, no reflow, and cardiac arrest. -
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表 1 患者临床资料及基线特征
Table 1. General data
例(%), X±S 临床资料 数值 年龄/岁 64.0±9.2 男性 37(82.2) 高血压 33(73.3) 糖尿病 12(26.6) 吸烟 24(53.3) 卒中史 7(26.6) 心肌梗死病史 12(26.6) 既往PCI 6(13.3) 既往冠脉移植术 5(11.1) 总胆固醇/(mmol/L) 3.90±0.98 低密度脂蛋白胆固醇/(mmol/L) 2.32±0.68 糖化血红蛋白/% 6.41±1.49 左室舒张末期内径/cm 4.88±0.58 左心室射血分数/% 50.24±9.97 肌酐/(μmoI/L) 81.73±22.42 估算肾小球过滤/(mL/min/1.73 m2) 87.64±20.33 
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