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目的 观察支架高压扩张后的血管内超声 (IVUS)结果 ,并用其指导支架置入 ,探讨IVUS在高压扩张时代的应用价值。方法 对 84处病变进行支架置入 ,当达到冠状动脉 (冠脉 )造影理想的支架置入标准时 ,应用IVUS进行评价 ,符合IVUS理想的支架置入标准的病变归入不需进一步干预组 (NAI组 ) ,不符合IVUS理想的支架置入标准的病变归入需进一步干预组 (AI组 )。在IVUS指导下对AI组进行进一步干预 ,直到符合IVUS理想标准或最大压力达到 2 0 2 6 5kPa。比较AI组在首次扩张后和最终的IVUS结果以及最终两组之间的结果。结果 在首次高压扩张后 ,有 4 9(5 8 3% )处病变 (NAI组 )的IVUS结果符合理想的支架置入标准 ,35 (4 1 7% )处病变 (AI组 )的IVUS结果未达到理想的支架置入标准从而进行了更高压力的进一步扩张。AI组经过更高压力扩张后 ,最终有 2 9(82 9% )处病变达到理想的支架置入标准。支架内最小横截面积由 (7 3± 2 0 )mm2 增加至 (9 3±2 0 )mm2 (P <0 0 0 1) ,急性获益由 (71± 15 ) %增加至 (91± 15 ) % (P <0 0 0 1)。结论 即使采用了高压扩张 (12 15 9～ 14 18 6kPa)技术 ,也不能确保达到满意的支架扩张。对于高压扩张后造影结果满意但IVUS结果不理想的病变 ,在IVUS指导下的更高压力 (16 2 1 2?
Objective To observe the results of intravascular ultrasound (IVUS) after stent dilatation and to guide the stent implantation to explore the value of IVUS in the era of hyperbaric dilatation. Methods Eighty-four lesions were treated with stent implantation. When the standard of coronary artery (coronary artery) angiography was reached, IVUS was used to evaluate the results. The standard IVUS stent placement criteria were included in the criteria without further intervention (NAI Group), non-IVUS ideal stent placement criteria were classified as further intervention (AI group). The AI group was further intervened under the IVUS guidelines until the IVUS ideal was met or the maximum pressure reached 2 0 2 6 5 kPa. The outcomes of the AI group after the initial dilatation and the final IVUS outcome and finally between the two groups were compared. Results After the first high-pressure dilatation, the IVUS results of 49 (58%) lesions (NAI group) met the ideal stent placement criteria, while the IVUS results of 35 (41.7%) lesions Achieving the ideal stent placement standard resulted in further expansion of higher pressures. At higher pressure in the AI group, 29 (82.9%) eventually achieved the ideal stent placement criteria. The smallest cross-sectional area in the stent increased from (73 ± 20) mm2 to (93 ± 20) mm2 (P <0.01), and the acute benefit increased from (71 ± 15)% to (91 ± 15 )% (P <0 0 0 1). Conclusion Even with the high-pressure expansion (12159 ~ 1418 6kPa) technology, can not ensure satisfactory stent expansion. For patients with satisfactory results after high-pressure dilatation and IVUS results are not satisfactory, under the guidance of IVUS higher pressure (16 2 1 2?