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目的比较准分子激光与旋磨及常规球囊对冠状动脉支架内再狭窄治疗的效果。方法将461例单支冠状动脉病变支架内再狭窄患者分别用准分子激光、旋磨术与常规球囊进行扩张治疗,并在治疗后即刻及6个月时再次行冠状动脉造影并进行定量分析。结果介入治疗前各组间支架内再狭窄情况无明显区别;准分子激光和旋磨后加PTCA即刻所获得的冠状动脉支架内最小血管直径(MLD)显著高于常规球囊治疗组(P<0.05),且旋磨与准分子激光组间无明显差异(P>0.05);6个月后准分子激光及旋磨组治疗组冠状动脉支架内血管直径明显低于常规球囊治疗组(P<0.05),且旋磨及准分子激光组无显著性差异(P>0.05)。旋磨与准分子激光及常规球囊治疗组支架内血管直径狭窄率分别为57.17%、54.78%及38.31%;准分子激光及旋磨组后期血管丢失量高于常规球囊治疗组(P<0.05)。结论准分子激光及旋磨对冠状动脉支架内再狭窄即刻疗效明显优于常规球囊治疗组,但6个月后支架内再狭窄率高于常规球囊治疗组,因而不宜首选用作支架内再狭窄的治疗。
Objective To compare the effects of excimer laser, rotational atherectomy and conventional balloon therapy on coronary stent restenosis. Methods 461 patients with coronary artery stenosis were treated with excimer laser, rotational atherectomy and conventional balloon dilatation, and coronary angiography was performed again immediately and 6 months after treatment. . Results There was no significant difference in stent restenosis between the two groups before interventional treatment. The diameter of coronary artery stent (MLD) obtained immediately after excimer laser plus rotational attrition plus PTCA was significantly higher than that of conventional balloon therapy group (P < 0.05). There was no significant difference between rotary and excimer laser groups (P> 0.05). After 6 months, the diameter of coronary vessels in the excimer laser group and the rotary mill group was significantly lower than that in the conventional balloon group <0.05), and there was no significant difference between rotary milling and excimer laser group (P> 0.05). The stenosis rates of stent diameter in rotational and excimer laser and conventional balloon therapy groups were 57.17%, 54.78% and 38.31%, respectively. The amount of vascular loss in the late stage of excimer laser and rotational atherectomy group was higher than that of conventional balloon therapy group (P < 0.05). Conclusion Excimer laser and rotational atherectomy in coronary stent restenosis was significantly better than the conventional balloon therapy group, but after 6 months in-stent restenosis rate was higher than conventional balloon therapy group, which should not be preferred for use as a stent Restenosis treatment.