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目的 旨在研究经皮冠状动脉 (冠脉 )内 β 射线放射疗法 (β 放疗 ,Novoste)与切割球囊成形术 (CBA)联合治疗支架内再狭窄 (ISR)的疗效及其安全性。方法 冠脉内支架置入术后ISR >70 %的病人 2 95例 [男性 2 0 5例 ,女性 90例 ,年龄 (5 9 76± 10 83)岁 ],其中 112例均行CBA联合 β 放疗为 β 放疗组 (n =112 ) ,183例单独采用CBA(89例 )或普通球囊扩张成形术 (94例 )为对照组 (n =183)。弥漫性长病变ISR者β 放疗先照射病变远段 ,再回撤导管照射病变近段。所有病例术前、术后即刻及术后随访期行冠脉造影 ,分析病变长度、最小管腔直径 (MLD)、参照管腔直径 (RLD)和管腔直径狭窄百分比 (DS)。随访靶血管再次成形率 (TVR)和主要不良心血管事件 (MACE)发生率。结果 术前及术后即刻两组病人的冠脉造影结果差异无显著性。随访期 (6 3± 1 6月 ) β 放疗组的MLD大于对照组 ,DS小于对照组 ,P <0 0 5。β 放疗组与对照组的心绞痛、心肌梗死及死亡率相似 ,差异无显著性(心绞痛为 10 %vs17% ,心肌梗死为 1%vs 2 % ,死亡率为 0 %vs2 % ) ,但β 放疗组的TVR和MACE明显低于对照组 (TVR为 5 %vs 16 % ,MACE为 10 %vs 2 5 % ,P <0 0 5 )。β 放疗组 2 8例 (2 6 % ,2 8 10 6 )弥漫性长病变ISR ,回撤 β 放疗导管分
The purpose of this study was to investigate the efficacy and safety of percutaneous coronary intervention (βRT) combined with cutting balloon angioplasty (CBA) in the treatment of in-stent restenosis (ISR). Methods A total of 2 95 patients (205 males and 90 females, mean age (59 76 ± 10 83) years) with ISR> 70% after coronary stenting were enrolled in this study. One hundred and twelve patients underwent CBA combined with beta-radiation In the beta radiotherapy group (n = 112), CBA (n = 183) alone or common balloon dilatation (n = 183) was used as control in 183 patients (n = 183). Diffuse long-pathological changes in patients with long-term ISR beta irradiation distal lesions, and then retracted catheter lesions proximal segment. Coronary angiography was performed preoperatively, immediately after operation, and postoperatively in all cases. The length of lesion, the minimum luminal diameter (MLD), the reference luminal diameter (RLD) and the percentage of lumen diameter stenosis (DS) were analyzed. Follow-up target vessel reshaping rate (TVR) and major adverse cardiac events (MACE) incidence. Results There was no significant difference between the two groups before and immediately after coronary angiography. The follow-up period (6 3 ± 1 6 months) in the β radiotherapy group was higher than that in the control group, and DS was smaller than that in the control group (P <0.05). β-radiation group and control group had similar angina pectoris, myocardial infarction and death rate, with no significant difference (angina pectoris 10% vs 17%, myocardial infarction 1% vs 2%, mortality 0% vs 2%), but β-radiation group TVR and MACE were significantly lower in the control group (TVR 5% vs 16%, MACE 10% vs 25%, P <0 05). β radiotherapy group 28 cases (26%, 2 8 10 6) diffuse long lesions ISR, withdrawal of β radiotherapy catheter points