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隐静脉搭桥血管经皮冠状动脉介入治疗的短期和长期临床结果

Short-term and long-term clinical outcomes of percutaneous coronary intervention on saphenous vein grafts.

作者信息

Nikfarjam Salman, Salari Arsalan, Mirbolouk Fardin, Pourrajabi Aseme, Ghasemi Mohammad, Ghadiri Asli Seyed Amir, Masoum Zadeh Kiaee Seyedeh Behnaz, Fakhr-Mousavi Seyed Aboozar, Ghafari Mohammad Ebrahim

机构信息

Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

ARYA Atheroscler. 2024;20(3):7-11. doi: 10.48305/arya.2024.41338.2867.

Abstract

BACKGROUND

Ischemic heart disease (IHD) is the leading cause of 16% of deaths globally. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are the main treatment options. Saphenous vein grafts (SVGs) remain the most frequently used conduits for CABG. In addition, PCI in cases previously undergoing CABG is related to worse long-term outcomes. This study aimed to evaluate PCI's short-term and long-term clinical outcomes on SVGs.

METHODS

Sixty-three patients who underwent PCI on SVGs from 2017 to 2019 were enrolled. Short-term and long-term cardiac outcomes of patients in the 6-month follow-up, including major adverse cardiac events (MACE) and all causes of death, were collected. The collected data were also analyzed through statistical methods.

RESULTS

The mean age of the subjects was 63.26 ± 8.74 years. Out of 63 patients, five patients (7.94%) died. Two of them died because of cardiac death a day after PCI, and three other cases passed away during the 6 months after angioplasty. Four and three cases had non-fatal myocardial infarction and stroke 6 months after PCI, respectively.

CONCLUSION

In conclusion, in patients with coronary artery disease, PCI and CABG are complementary therapies. Revascularization on saphenous vein grafts seems to be a safe and practical technique in patients.

摘要

背景

缺血性心脏病(IHD)是全球16%死亡病例的主要原因。经皮冠状动脉介入治疗(PCI)和冠状动脉旁路移植术(CABG)是主要的治疗选择。大隐静脉移植物(SVG)仍然是冠状动脉旁路移植术中最常用的血管 conduit。此外,既往接受过冠状动脉旁路移植术的患者进行经皮冠状动脉介入治疗与较差的长期预后相关。本研究旨在评估经皮冠状动脉介入治疗对大隐静脉移植物的短期和长期临床疗效。

方法

纳入2017年至2019年接受大隐静脉移植物经皮冠状动脉介入治疗的63例患者。收集患者在6个月随访中的短期和长期心脏结局,包括主要不良心脏事件(MACE)和所有死因。对收集的数据也采用统计学方法进行分析。

结果

受试者的平均年龄为63.26±8.74岁。63例患者中,5例(7.94%)死亡。其中2例在经皮冠状动脉介入治疗后一天因心源性死亡,另外3例在血管成形术后6个月内死亡。分别有4例和3例在经皮冠状动脉介入治疗6个月后发生非致命性心肌梗死和中风。

结论

总之,在冠心病患者中,经皮冠状动脉介入治疗和冠状动脉旁路移植术是互补的治疗方法。大隐静脉移植物血运重建对患者来说似乎是一种安全实用的技术。

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本文引用的文献

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Saphenous Vein Graft Failure: From Pathophysiology to Prevention and Treatment Strategies.
Circulation. 2021 Aug 31;144(9):728-745. doi: 10.1161/CIRCULATIONAHA.120.052163. Epub 2021 Aug 30.
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Outcomes of primary percutaneous cardiac intervention for ST elevation myocardial infarction with a saphenous vein graft culprit.
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