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药物涂层球囊血管成形术治疗初发冠状动脉病变后的血管造影模式

Angiographic patterns after drug-coated balloon angioplasty for de novo coronary lesions.

作者信息

Funayama Naohiro, Kayanuma Keigo, Sunaga Daisuke, Furugen Makoto

机构信息

Division of Cardiovascular Medicine, Hokkaido Cardiovascular Hospital, Sapporo, Japan.

出版信息

AsiaIntervention. 2024 Jul 26;10(2):119-125. doi: 10.4244/AIJ-D-23-00064. eCollection 2024 Jul.

Abstract

BACKGROUND

Drug-coated balloon (DCB) angioplasty has emerged as an effective treatment option for coronary artery lesions; however, the chronic-phase angiographic patterns after DCB angioplasty for lesions have not yet been described.

AIMS

The aim of the present study was to evaluate chronic-phase angiographic classification after DCB angioplasty.

METHODS

This was a single-centre, retrospective, observational study. From June 2016 to August 2022, 708 lesions (670 patients) underwent DCB angioplasty for coronary lesions. Successful DCB angioplasty was defined as a non-flow-limiting dissection, with residual stenosis ≤30% and absence of a bailout stent. A total of 337 lesions (318 patients) were enrolled in this study.

RESULTS

Of the 337 lesions analysed, 91.1% (n=307) were in the non-restenosis group, and 8.9% (n=30) were in the restenosis group. The non-restenosis group was classified into non-restenosis (45.1%; n=152) and lumen enlargement (46.0%; n=155). The restenosis group was classified into focal restenosis (5.0%; n=17), diffuse restenosis (3.6%; n=12), and occlusive restenosis (0.3%; n=1). There were no aneurysms, and plaque cavities were often observed (8.0%). During the chronic phase, residual dissection was seen in only one case (0.3%).

CONCLUSIONS

This report demonstrates for the first time the angiographic classification after DCB angioplasty for coronary lesions. Restenosis patterns were seen in 8.9% of lesions, and half of the restenosis patterns presented a focal restenosis pattern. Late lumen enlargement was observed in 46% of the treated lesions.

摘要

背景

药物涂层球囊(DCB)血管成形术已成为冠状动脉病变的一种有效治疗选择;然而,DCB血管成形术后病变的慢性期血管造影模式尚未见描述。

目的

本研究的目的是评估DCB血管成形术后的慢性期血管造影分类。

方法

这是一项单中心、回顾性、观察性研究。2016年6月至2022年8月,708处病变(670例患者)接受了DCB冠状动脉病变血管成形术。成功的DCB血管成形术定义为无血流限制性夹层,残余狭窄≤30%且未置入补救支架。本研究共纳入337处病变(318例患者)。

结果

在分析的337处病变中,91.1%(n = 307)属于无再狭窄组,8.9%(n = 30)属于再狭窄组。无再狭窄组分为无再狭窄(45.1%;n = 152)和管腔扩大(46.0%;n = 155)。再狭窄组分为局灶性再狭窄(5.0%;n = 17)、弥漫性再狭窄(3.6%;n = 12)和闭塞性再狭窄(0.3%;n = 1)。未发现动脉瘤,常观察到斑块空洞(8.0%)。在慢性期,仅1例(0.3%)出现残余夹层。

结论

本报告首次展示了DCB冠状动脉病变血管成形术后的血管造影分类。8.9%的病变出现再狭窄模式,其中一半的再狭窄模式为局灶性再狭窄模式。46%的治疗病变观察到晚期管腔扩大。

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