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准分子激光冠状动脉成形术:临床结果的小型叙述性综述。

Excimer laser coronary angioplasty: a mini-narrative review of clinical outcomes.

作者信息

Olatunji Gbolahan, Kokori Emmanuel, Aboje John, Mohammed Saad, Asifat Olamide, Isarinade David Timilehin, Yusuf Ismaila Ajayi, Olawade David B, Aderinto Nicholas

机构信息

Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria.

College of Health Sciences, Benue State University, Benue, Nigeria.

出版信息

Egypt Heart J. 2024 Sep 16;76(1):129. doi: 10.1186/s43044-024-00561-8.

Abstract

BACKGROUND

Excimer laser coronary angioplasty (ELCA) has evolved as a pivotal element in percutaneous coronary intervention (PCI), significantly influencing procedural efficacy and safety. This mini-narrative review explores ELCA's applications, focusing on its efficacy and clinical outcomes. BODY: A search of major databases identified studies from ELCA's inception. Inclusion criteria encompassed diverse study designs exploring ELCA in coronary interventions, with rigorous data extraction ensuring accuracy and completeness. A narrative synthesis presented key findings across studies. ELCA demonstrated promising outcomes compared to traditional PCI and stent placement. Reduced reperfusion time, enhanced microcirculation, and lower postoperative major adverse cardiac events (MACE) rates highlighted its efficacy. Improved vascular and lumen dynamics, plaque modification, and successful treatment of complex lesions showcased its versatility. Quality of life enhancements positively impacted long-term recovery, particularly in acute coronary syndrome (ACS) cases. ELCA's success in challenging scenarios and its role in refining in-stent restenosis (ISR) treatment indicated broader applications. Despite limitations in some studies, ELCA presented a favorable safety profile.

CONCLUSION

The review underscores ELCA's dynamic role in coronary interventions, offering a promising tool for enhancing procedural outcomes. Clinical implications include improved reperfusion, adaptability in complex lesions, and potential long-term benefits for ACS patients. While integration into routine practice requires careful consideration, ELCA's positive outcomes encourage further exploration and innovation in interventional cardiology.

摘要

背景

准分子激光冠状动脉成形术(ELCA)已发展成为经皮冠状动脉介入治疗(PCI)的关键要素,对手术疗效和安全性产生了重大影响。本小型叙述性综述探讨了ELCA的应用,重点关注其疗效和临床结果。

主体

对主要数据库进行检索,确定了自ELCA开展以来的研究。纳入标准包括探索ELCA在冠状动脉介入治疗中的各种研究设计,并进行严格的数据提取以确保准确性和完整性。通过叙述性综合分析展示了各项研究的关键发现。与传统PCI和支架置入术相比,ELCA显示出了有前景的结果。再灌注时间缩短、微循环改善以及术后主要不良心脏事件(MACE)发生率降低突出了其疗效。血管和管腔动力学改善、斑块修饰以及复杂病变的成功治疗展示了其多功能性。生活质量的提高对长期恢复产生了积极影响,尤其是在急性冠状动脉综合征(ACS)病例中。ELCA在具有挑战性的情况下取得的成功及其在改善支架内再狭窄(ISR)治疗中的作用表明了其更广泛的应用前景。尽管在一些研究中存在局限性,但ELCA呈现出良好的安全性。

结论

该综述强调了ELCA在冠状动脉介入治疗中的动态作用,为提高手术效果提供了一个有前景的工具。临床意义包括改善再灌注、对复杂病变的适应性以及对ACS患者的潜在长期益处。虽然将其纳入常规实践需要仔细考虑,但ELCA的积极结果鼓励在介入心脏病学领域进行进一步探索和创新。

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