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目的:探讨应用切割球囊预扩张后置入金属裸支架治疗冠状动脉开口病变的远期临床疗效。方法:对66例有冠状动脉开口病变的患者行切割球囊预扩张后置入金属裸支架,并对上述患者进行了6～8个月的冠状动脉造影随访和4年的临床随访。66例中冠状动脉主干开口病变9例,前降支开口病变50例,回旋支和右冠脉动脉开口病变各为3例和4例。按照切割球囊与血管直径1:1的原则,选择切割球囊的大小。结果:66例患者中完成经皮冠状动脉介入治疗(PCI)术后6～8个月冠状动脉造影随访者38例,造影随访率为57.6%,其中9例发生支架内再狭窄。66例中完成4年临床随访55例,其中死亡2例,1例于冠状动脉旁路移植(CABG)术后死亡,1例死于肺癌,发生非 Q 波心肌梗死2例,均由支架内严重再狭窄所致,经再次 PCI 治疗成功。4年间行血管重建术8例,其中再次 PCI 4例,行 CABG 4例,总计心脏事件发生率为16.4%(9/55)。结论:本研究显示切割球囊预扩张后置入金属裸支架有良好的近远期效果,未发现有晚期血栓形成致心脏事件的证据。
OBJECTIVE: To investigate the long-term clinical efficacy of open-ended metal balloon stenting for coronary artery stenosis after pre-dilation of the cutting balloon. Methods: Sixty-six patients with coronary artery stenosis underwent pre-dilation of the incision balloon and then placed into a bare metal stent. The patients were followed up for 6 to 8 months with coronary angiography and followed up for 4 years. In 66 cases, 9 cases of coronary artery stenosis, 50 cases of anterior descending coronary artery occlusion, 3 cases of open circumflex branch and right coronary artery were found in 4 cases. In accordance with the principle of cutting the balloon and blood vessel diameter 1: 1, choose the size of the cutting balloon. Results: Thirty-eight follow-up coronary angiography was performed in 6 to 8 months after percutaneous coronary intervention (PCI) in 66 patients. The follow-up rate was 57.6%. Nine of 9 patients had in-stent restenosis. Sixty-four patients were followed up for 4 years in 55 patients, including 2 deaths, 1 died of coronary artery bypass graft (CABG), 1 died of lung cancer and 2 cases of non-Q wave myocardial infarction Severe restenosis caused by successful PCI again. In 4 years, 8 cases underwent revascularization. Among them, 4 cases were re-PCI, and 4 cases received CABG. The total incidence of cardiac events was 16.4% (9/55). CONCLUSIONS: This study shows good near-to-long-term effects of implanted bare metal scaffolds after pre-dilatation of the balloon and no evidence of cardiac events due to advanced thrombosis.