紫杉醇药物涂层球囊扩张冠状动脉支架内再狭窄病变增加远期管腔面积

发布时间：2018-05-16 19:27

本文选题：药物涂层球囊 + 支架内再狭窄　；参考：《介入放射学杂志》2017年04期

【摘要】：目的探讨以单纯紫杉醇药物涂层球囊(DCB)扩张冠状动脉介入治疗术后支架内再狭窄(ISR)病变段,观察远期靶血管管腔面积,从而证实DCB在ISR病变中的作用。方法选取4例符合DCB适应证ISR患者,按照标准流程在充分预扩张基础上予以紫杉醇DCB扩张病变段,不植入支架。术后即刻及术后9个月采用冠状动脉造影和血管内超声检测患者最小管腔横截面积(MLA)、支架横截面积(SA)和血管内膜增生状况。结果 4例患者单纯紫杉醇DCB治疗后即刻造影显示靶血管扩张段无夹层,无明显残余狭窄。术后9个月造影显示所有患者靶血管扩张段管腔通畅,病变段未见明显再狭窄,TIMI血流3级;血管内超声检测显示MLA均较术后即刻显著增加,SA呈增加趋势,内膜增生呈抑制趋势。结论单纯DCB扩张ISR病变可增加远期管腔面积,避免二次支架植入,降低再次ISR风险,并通过局部释放紫杉醇作用于管壁,抑制内膜过度增生。
[Abstract]:Objective to investigate the angioplasty of restenosis after percutaneous coronary intervention with paclitaxel coated balloon, and to observe the long term target vascular lumen area, so as to confirm the role of DCB in the pathogenesis of ISR. Methods four patients with ISR according to DCB indication were selected and treated with paclitaxel DCB on the basis of full predilation according to the standard procedure without stent implantation. Coronary angiography and intravascular ultrasound were used to detect the minimum lumen cross sectional area (MLAA), stent cross sectional area (SAA) and intimal hyperplasia in patients immediately after operation and 9 months after operation. Results immediately after paclitaxel DCB alone, 4 patients showed no dissection and no residual stenosis in the target vasodilation segment. 9 months after operation, the angiographic findings showed that the lumen of target vasodilation segment was patency, no restenosis was found in the lesion segment and TIMI blood flow was grade 3. Intravascular ultrasound examination showed that MLA increased significantly compared with that immediately after operation, and intimal hyperplasia showed an increasing trend, while intimal hyperplasia showed a tendency of inhibition. Conclusion simple DCB dilatation of ISR can increase long-term lumen area, avoid secondary stent implantation, reduce the risk of re-ISR, and inhibit intimal hypertrophy by local release of paclitaxel.
【作者单位】：上海交通大学附属第六人民医院心内科;
【分类号】：R543.3

【相似文献】