聚乙烯醇颗粒治疗Ⅱ型和Ⅲ型冠状动脉穿孔的安全性和有效性

Safety and Efficacy of Polyvinyl Alcohol Granules in Treating Type II and III Coronary Artery Perforation.

作者信息

Wang Jun, Liu Yuan, Jin Guo-Zhen

机构信息

Department of Cardiology, Hongze District People's Hospital, Huaian, 223100, People's Republic of China.

Community Health Service Center of Huaihai Road, Nanjing, 210002, People's Republic of China.

出版信息

Int J Gen Med. 2024 Aug 23;17:3663-3670. doi: 10.2147/IJGM.S474746. eCollection 2024.

DOI:10.2147/IJGM.S474746

PMID:39193260

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11348980/

Abstract

OBJECTIVE

The success rate of polyvinyl alcohol (PAV) granules in the treatment of coronary artery perforation (CAP) was investigated to determine their safety and efficacy.

METHODS

Forty patients with II and III coronary artery perforations during percutaneous coronary intervention were divided into two groups. One group was only occluded by low pressure balloons (balloon occlusion group), and the other one was occluded with PVA granules during low-pressure balloon dilatation (PVA granules embolization group). Retrospective analysis of clinical data was used to compare the success rate and safety of various methods.

RESULTS

The balloon embolization group had 16 cases (88.9%) of coronary perforation type II and 2 cases (11.1%) of coronary perforation type III. The PVA granules embolization group had 20 cases (90.9%) of coronary perforation type II and 2 cases (9.1%) of coronary perforation type III. Of the 18 patients in the balloon occlusion group, 13 were immediately occluded, with a success rate of 72.2%, while the remaining 5 required embolization or covered stents. 6 of the 18 patients had pericardial effusion, and two of them underwent pericardiocentesis. Among the 22 patients in the PVA granules embolization group, 21 were immediately blocked, with a 95.5% success rate, while the other was occluded by a covered stent. The results revealed that the success rate of transcatheter closure in the PVA granules embolization group was significantly higher than that in the balloon embolization group, and the risk of pericardial effusion and pericardiocentesis in the PVA granules embolization group was significantly lower than that in the balloon embolization group.

CONCLUSION

In comparison to the simple use of low-pressure balloon occlusion, the use of PAV granules in the treatment of II, III coronary artery perforation has a high success rate and safety, and is a viable method for treating coronary artery perforation.

摘要

目的

研究聚乙烯醇（PAV）颗粒治疗冠状动脉穿孔（CAP）的成功率，以确定其安全性和有效性。

方法

将40例经皮冠状动脉介入治疗期间发生Ⅱ型和Ⅲ型冠状动脉穿孔的患者分为两组。一组仅用低压球囊封堵（球囊封堵组），另一组在低压球囊扩张时用PVA颗粒封堵（PVA颗粒栓塞组）。采用回顾性分析临床资料的方法比较各种方法的成功率和安全性。

结果

球囊栓塞组Ⅱ型冠状动脉穿孔16例（88.9%），Ⅲ型冠状动脉穿孔2例（11.1%）。PVA颗粒栓塞组Ⅱ型冠状动脉穿孔20例（90.9%），Ⅲ型冠状动脉穿孔2例（9.1%）。球囊封堵组18例患者中，13例立即封堵成功，成功率为72.2%，其余5例需要栓塞或覆膜支架治疗。18例患者中有6例发生心包积液，其中2例行心包穿刺术。PVA颗粒栓塞组22例患者中，21例立即封堵成功，成功率为95.5%，另1例采用覆膜支架封堵。结果显示，PVA颗粒栓塞组经导管封堵成功率明显高于球囊栓塞组，PVA颗粒栓塞组心包积液和心包穿刺的风险明显低于球囊栓塞组。