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目的 :评价后退式旋切导管 (PAC)治疗冠状动脉支架内再狭窄病变的有效性和安全性以及其即刻和近期定量冠状动脉造影结果。方法 :17例支架内再狭窄病变采用PAC治疗 ,应用定量冠状动脉造影评价即刻和近期疗效 ,并与同期的 38例首次介入治疗病变进行比较。结果 :支架内再狭窄组与首次介入治疗组相比PAC器械成功率分别为 10 0 %∶92 %、即刻造影残余狭窄率为 (36± 10 ) %∶(35± 15 ) %、斑块组织获取率为 94 %∶94 % ,两组差异无显著性意义 (P >0 .0 5 )。PAC所产生的血管腔直径增益为 (0 .78± 0 .6 6 )mm ,略低于首次介入治疗者〔(0 .97± 0 .5 5 )mm〕。PAC造成的主要并发症包括原置入支架带出 2例 ,血管内膜撕裂 3例。 6个月随访造影血管腔直径丢失指数为 0 .4 6± 0 .4 5 ,略低于首次介入治疗组 (0 .5 7± 1.13)。造影再狭窄率为 2 9% ,与首次介入治疗组相近 (2 6 % )。结论 :PAC能有效地用于冠状动脉支架内再狭窄病变的处理 ,具有较理想的即刻和近期有效率。
PURPOSE: To evaluate the efficacy and safety of a retrograde circumcision catheter (PAC) in the treatment of coronary stent restenosis and its immediate and recent quantitative coronary angiography. Methods: Twenty-seven cases of in-stent restenosis were treated with PAC. The immediate and immediate curative effects were evaluated by quantitative coronary angiography and compared with the first interventional treatment in 38 cases. Results: Compared with the first interventional treatment group, the success rate of PAC instrument in restenosis group was 100% and 92% respectively, and the immediate residual stenosis rate was 36 ± 10% and 35 ± 15% Obtaining rate was 94%: 94%, no significant difference between the two groups (P> 0.05). The diameter gain of the lumen produced by PAC was (0.78 ± 0.66) mm, slightly lower than that of the first intervention [(0 .97 ± 0.55) mm]. The main complications caused by PAC include the original placement of stent out of 2 cases, 3 cases of vascular intimal tear. The 6-month follow-up angiographic vessel lumen loss index was 0.46 ± 0.45, slightly lower than the first intervention group (0.57 ± 1.13). The contrast-induced restenosis rate was 29%, similar to the first intervention group (26%). Conclusion: PAC can be effectively used in the treatment of coronary stent restenosis with immediate and immediate efficiency.