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应用 Shin 方法评估生物可吸收依维莫司洗脱血管支架治疗粥样硬化性冠状动脉病变血管壁内容物的系列变化:一项 IVUS 研究。

Assessment of the serial changes of vessel wall contents in atherosclerotic coronary lesion with bioresorbable everolimus-eluting vascular scaffolds using Shin's method: an IVUS study.

机构信息

Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

出版信息

Int J Cardiovasc Imaging. 2011 Oct;27(7):931-7. doi: 10.1007/s10554-010-9739-4. Epub 2010 Nov 16.

Abstract

Although serial changes in necrotic core and calcium are regarded as surrogates for the bioresorption process in patients treated with the bioresorbable everolimus-eluting vascular scaffolds (BVS), these temporal changes have not yet been fully investigated. Shin's method may be offer a more suitable technique for this analysis because it includes all the contents of both the lumen and vessel wall. The purpose of this study was to assess the serial changes of necrotic core and dense calcium content in coronary lesions that were treated with a BVS implant using Virtual Histology intravascular ultrasound (VH-IVUS) analyzed using Shin's method. A total of 29 patients (92 coronary segments) were imaged to evaluate the serial changes in necrotic core and dense calcium using Shin's method. Lesions treated with a BVS implant were analyzed with serial VH-IVUS assessments, i.e., pre- and post-stenting, and at 6 months and 2 years follow-up. In Shin's method contours are drawn around the IVUS catheter (instead of delineating the lumen) and the vessel. The mean necrotic core area decreased by 6.9% from post-stenting to 6 months (1.71 ± 1.03 mm² vs. 1.36 ± 0.91 mm², P = 0.027), and by 20.5% (1.71 ± 1.03 mm² vs. 1.20 ± 0.70 mm², P = 0.003) from post-steting to 2 years; while the mean dense calcium areas decreased by 27.2% (1.07 ± 0.55 mm² vs. 0.78 ± 0.64 mm², P = 0.039) from post-stenting and 2 years. At 2 years, absolute necrotic core and dense calcium content were significantly decreased as compared to post-stenting values. The present study demonstrates that the bioresorption process in patients who undergoing BVS device implantation can be assessed using VH-IVUS analysed using Shin's method.

摘要

虽然坏死核心和钙的连续变化被认为是生物可吸收依维莫司洗脱血管支架(BVS)治疗患者生物吸收过程的替代物,但这些时间变化尚未得到充分研究。Shin 方法可能为此分析提供更合适的技术,因为它包含管腔和血管壁的所有内容。本研究旨在使用 Shin 方法分析的虚拟组织学血管内超声(VH-IVUS)评估 BVS 植入物治疗的冠状动脉病变中坏死核心和致密钙含量的连续变化。对 29 例患者(92 个冠状动脉节段)进行成像,使用 Shin 方法评估坏死核心和致密钙的连续变化。对 BVS 植入物治疗的病变进行连续 VH-IVUS 评估,即在支架置入术前、支架置入后以及 6 个月和 2 年随访时。在 Shin 方法中,轮廓是围绕 IVUS 导管(而不是描绘管腔)和血管绘制的。从支架置入后到 6 个月,平均坏死核心面积减少 6.9%(1.71±1.03mm² 比 1.36±0.91mm²,P=0.027),从支架置入后到 2 年减少 20.5%(1.71±1.03mm² 比 1.20±0.70mm²,P=0.003);而平均致密钙面积从支架置入后和 2 年减少 27.2%(1.07±0.55mm² 比 0.78±0.64mm²,P=0.039)。与支架置入后相比,2 年后绝对坏死核心和致密钙含量明显减少。本研究表明,使用 Shin 方法分析的 VH-IVUS 可评估接受 BVS 装置植入的患者的生物吸收过程。

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