在冠状动脉慢性闭塞性病变介入治疗中两种指引导丝操作技术的...

郭炜华 王国宏 吴明营 陈波 王雷 刘君 马志敏 陈

摘要 目的 观察应用以球囊对普通指引导丝（中等硬度3～6 g）支撑作冠状动脉慢性闭塞性病变(CTO)的介人治疗的可行性、安全性和效果。方法 2009年3月至2011年3月入院行冠脉造影检查发现有CTO病变并行经皮冠脉介入(PCI)治疗的患者108例(陈旧性心肌梗死59例，不稳定型心纹痛22例，稳定型心纹痛27例)。介入治疗的病例分为单独使用指引导丝的病例组与以球囊支撑普通指引导丝的病例组，比较两组患者手术成功率、并发症发生率。结果 108例CTO病变88例(81%)获得成功，20例未成功，单用导丝组与球囊支撑导丝组成功率分别为52/65(80%)与36/43(84%)两组对比差异无统计学意义 ( P＞ 0.05)。并发症指引导丝组7/65(10.8%)高于普通指引导丝球囊支撑组1/43(2.3%)(P＜0.05)。术中无死亡病例，术后住院期间无主要不良心脏事件(MACE)发生。结论 以球囊支撑普通指引导丝做CTO 安全方便，成功率较高。北京同仁医院心血管疾病诊疗中心郭炜华

关键词 冠状动脉慢性闭塞病变 经皮冠状动脉介入术 指引导丝 球囊

Efficacy and safety of coronary intervention treatment used by the guidewire depended on ballon with chronic total occlusions GUO Wei-hua, WANG Guo-hong, WU Ming-ying, CHEN Bo, WANG Lei, LIU Jun, MA Zhi-min, CHEN Zhe. Department of Cardiology, Beijing Tongren Hospital of Capital Medical University, Beijing 100176, China

Abstract: Objective To perform a retrospective analysis of the efficacy and safety of percutaneous coronary intervention ( PCI) treatment used by the guide wire depended on a ballon with chronic total occlusions (CTO). Methods Patients with CTO confirmed by coronary angiography and treated by PC I between march 2009 and June 2010 were enrolled in our study (n=108). in which old myocardial infarction(n=59), instable angina (n=22), and stable angina (n=27) included, were _______________

作者单位：北京 100176首都医科大学附属北京同仁医院心脏中心

通信作者：郭炜华Email:Weihuaguo2005@163.com. 13466401343

analyzed retrospectively. The clinical data, outcomes of PCI, perioperative complications and the incidence of major adverse cardiac events (MACE) during follow up were retrospectively analyzed between Group A (patients only used by guide wire ) and Group B ( the guide wire depend on balloon). Results the success rate of CTO in the Group B(80%) were higher than those in Group A (84%). No statistical difference was found in the success rate of patients between the two groups . The rate of total complications in group one was more than the group B(10.8 % vs2.8% P<0.05).No death occurred during operation, no major adverse cardiac events(MACE) occurred after operation in hospital and no patients undertook emergency coronary artery bypass graft(CABG) in the two groups. Conclusion　A relatively high success rate of PCI and safety can be achieved used by the guide wire depended on balloons with CTO.

Key words: chronic total occlusion; percutaneous coronary interventiona; guidewie; ballon