后扩张在老年患者钙化病变PCI术中应用的临床研究

目的观察后扩张在老年患者冠状动脉钙化病变经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术中应用的疗效和安全性。方法选择PCI血管造影成功的老年钙化血管造影病变患者124例,随机分为后扩张组(62例)和对照组(常规置入组;62例),观察两组患者PCI术中并发症发生率及住院期间及术后1年支架内血栓、再狭窄和主要不良心脏事件(major adverse cardiac events,MACE)发生率。结果后扩张组和常规置入组患者PCI术中并发症发生率两组间比较差异无显著性(6.5%︰4.8%,P>0.05);1年时的随访结果显示,后扩张组的MACE发生率较对照组降低(4.8%︰12.9%,P<0.05);支架内血栓和支架内再狭窄发生率较常规置入组均明显减少(1.6%︰4.8%;4.4%︰14.3%,P<0.05),差异有显著性。结论在老年钙化病变患者PCI术中应用后扩张治疗安全、有效,能够降低支架内血栓、再狭窄和MACE发生率。

Observation on therapeutic effects of post-dilatation for elderly patients with coronary artery calcification lesion

Objective To observe the clinical therapeutic effect and security of adjunctive balloon postdilatation applying to percutaneous coronary intervention for elderly patients with coronary artery calcification lesion. Methods 124 elderly patients with coronary artery calcification lesion and successful angiograph in our hospital were randomly divided into the post-dilatation deployment group (n=62) and the control group (n=62). The complications of intraoperative and stent thrombosis, stent restenosis and major adverse cardiac events (MACE) within hospitalization and one year were observed. Results Intraoperative complications were similar between the two groups (6.5%︰4.8%, P>0.05). Stent thrombosis, stent restenosis, major adverse cardiac events were significantly lower in post-dilatation deployment group than in control group at 1 year. (1.6%︰4.8%; 4.4%︰14.3%; 4.8%︰12.9%. all P<0.05). Conclusions Routine post-dilatation approoach is safe and effective for elderly patients with coronary artery calcification lesion undergoing PCI. It was assosiated lower stent thrombosis, stent restenosis, major adverse cardiac events and improved prognosis.