冠状动脉严重钙化病变的旋磨术后植入药物洗脱长支架的长期临床.docVIP

·述 评· 冠状动脉严重钙化病变的旋磨术后植入药物洗脱长支架的长期临床疗效观察 彭 剑, 鲁锦国*, 徐承义, 严亚林, 宋 丹, 陈国洪, 苏 晞 （武汉亚洲心脏病医院心内科, 武汉 430000） 【摘 要】目的 探讨冠状动脉旋（简称“冠脉”）磨术联合药物洗脱长支架在治疗严重冠脉钙化病变的安全性及有效性。方法 入选2010年1月至2010年12月因严重冠脉钙化而行冠脉旋磨术联合药物洗脱长支架植入治疗的患者。观察患者的手术成功率，围手术并发症及术后主要心血管事件（包括心源性死亡、心肌梗死、靶病变血运重建）的发生率。结果 共21例严重冠脉钙化病变患者接受了冠脉旋磨术联合药物洗脱长支架植入治疗，平均年龄为（65.2±6.9）岁。合并高血压病16例（76.2%），糖尿病7例（33.3%），肾功能不全1例（4.8%）。旋磨部位共植入35枚国产药物支架（1.75枚/部位，最短支架为28mm，病变部位平均支架总长度为48mm（29～66mm），仅1例因旋磨头未能通过病变而放弃，手术成功率为95.2%（20/21）。术中1例出现冠脉痉挛，1例出现胸痛伴心率减慢；术后1例出现消化道出血。住院期间无心血管事件发生，平均26月的随访期间，仅1例（4.8%）患者于术后第2月发生急性心肌梗死，余患者病情稳定。结论 冠脉旋磨术联合药物洗脱长支架植入术治疗严重冠脉钙化病变可取得很高的手术成功率，是治疗钙化病变安全、有效的方法。 【关键词】冠状动脉疾病; 药物洗脱支架; 冠状动脉旋磨术; 钙化病变 【中图分类号】 R541.4 【文献标识码】 A 【DOI】 ? Rotational atherectomy followed by long drug-eluting stent implantation for severe coronary artery calcified lesions: a long-term clinical observation PENG Jian, LU Jinguo, XU Chengyi, YAN Yalin, SONG Dan, CHEN Guohong, SU Xi (Department of Cardiology, Wuhan Asian Heart Hospital, Wuhan 430000, China) 【Abstract】 Objective To assess the safety and efficiency of long-term outcome after rotational atherectomy (RA) followed by long drug-eluting stent (DES) implantation in severe calcified coronary lesions. Methods Patients with severe calcified coronary lesions treated with RA followed by long DES in our department between Janury and December 2010 were enrolled. Their procedural success rate, preoperative complications, and postoperative major adverse cardiovascular events ((MACE, including cardiac death, myocardial infarction and target lesion revascularization) were recorded and analyzed. All patients were available for our long-term follow-up. Results Twenty-one patients with complex calcified coronary lesions were treated with RA followed by long DES, with their mean age of 65.2+6.9. There were 16 patients (76.2%) having hypertension, 7 (33.3%) having diabetes mellitus and 1 (4.8%) having chronic renal failure. There were totally 35 stents implantated in 20 calcified coronary