冠状动脉内旋磨术治疗前降支球囊无法通过慢性重度钙化病变

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1、冠状动脉内旋磨术治疗前降支球囊无法通过慢性重度钙化病变【摘要】目的：探讨冠状动脉斑块旋磨术治疗前降支球囊难以通过的慢性重度钙化病变的可行性和安全性。方法：回顾性分析了我院2012.1-2012.12完成择期冠脉斑块旋磨术治疗前降支慢性钙化病变11例，平均年龄67.27±9.59岁，合并糖尿病者2例，合并高血压者8例。造影结果显示11例冠状动脉钙化病变患者的11处钙化病变狭窄程度为70%-100%,病变处接受冠状动脉旋磨术治疗及经皮冠状动脉球囊扩张及支架植入术。着重分析手术方法、手术成功率、术后随访主要

2、心血管事件的发生率。结果：11例患者均成功行冠状动脉旋磨术，术后均植入药物洗脱支架，手术即刻成功率100%o术中均无主要并发症（包括心源性死亡、Q波心肌梗死、心肌穿孔、急诊冠状动脉旁路移植术）发生。所有患者随访9-12个月。有1例再发心绞痛，无主要心血管事件（包括心源性死亡、心肌梗死、靶病变血运重建）发生。结论：冠状动脉旋磨术联合球囊扩张术和支架植入术治疗前降支钙化病变是安全、有效的方法，可取得很高的手术成功率。【关键词】冠状动脉旋磨术；前降支；钙化病变；支架植入术[Abstract】Objectiv

3、eToinvestigatethesafetyandefficacyofcoronaryrotationalatherectomyinthetreatmentofanteriordescendingarterycalcificationlesions.MethodsRetrospectiveanalysis11casesinvolvingbetweenJanuary1,2012andDecember31,2012diagnosedasanteriordescendingarterycalcificat

4、ionlesionsweretreatedwithcoronaryrotationalatherectomyretrospectively.Theaverageageof67.27±9.59yearsold.2patientshaddiabetesmellitusand8patientshadhypertension.Calcifiedlesionsinthedegreeofstenosisof70%to100%・11lesionsweretreatedwithrotationalatherectom

5、yandPTCA.Proceduralsuccessrateandclinicaleffectofpostoperativevisitingandmainadversecardiovasculareventswererecordedandfocusedon.ResuItsAlltheburrspassedthroughthelesionssuccessfully,stentswereplanted,theimmediatesuccessratewas100%・Nomainadversecardiova

6、scularevents(includingcardiacdeath,Qwavemyocardialinfarction,Myocardiumperforationandemergencycoronarysurgery)occurredduringoperation.Anginawasappearedin1casesandnomajoradversecardiacevents(includingcardiacdeath.myocardialinfarctionandtargetlesionrevasc

7、ularization)occurredduringfollow-upfor9~12months・ConclusionCoronaryrotationalatherectomycombinedwithPTCAandstentimplantationwaseffectiveandsafeinthetreatmentofanteriordescendingarterycalcificationlesions・Itpresentedahighproceduralsuccessrate.[keywords】C

8、oronaryrotationalatherectomy；anteriordescendingartery；Calcificationlesions；Stent【中图分类号】R541.4【文献标识码】B【文章编号】1005-0019(2013)12-0415-01冠状动脉内钙化病变始终都是PCI治疗的重点和难点之一，尤其是中重度钙化病变更是导致PCI手术成功率降低的重要因素。前降支通常是左主干的直接延续，作为左冠状动脉系统乃至整个心脏最重要的冠脉分支，提