Li Ben, Li Jiaxing, Hu Guangxin, Zhang Shichang, Ren Yongkang, Li Mingyang, Li Yinping, Jia Shaobin
Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan, People's Republic of China.
Ningxia Medical University, Yinchuan, People's Republic of China.
J Int Med Res. 2024 Dec;52(12):3000605241305369. doi: 10.1177/03000605241305369.
This study aimed to compare the efficacy and safety of intravascular ultrasound (IVUS)-guided coronary intravascular lithotripsy and rotational atherectomy in treating severe coronary artery calcification.
A retrospective analysis of 60 patients who underwent percutaneous coronary intervention at the General Hospital of Ningxia Medical University from October 2022 to August 2023 was conducted. The patients were divided into two groups: 30 received IVUS-guided coronary intravascular lithotripsy and 30 underwent IVUS-guided rotational atherectomy. The primary endpoints comprised angiographic thrombolysis in myocardial infarction III flow and <30% stenosis post-percutaneous coronary intervention, and IVUS metrics, such as >80% stent expansion, avoiding high plaque burden or lipid-rich plaques, minimizing malapposition <0.4 mm/1 mm, and preventing tissue prolapse and dissection. Safety was assessed by complications and 1- and 6-month postoperative major adverse cardiovascular event rates.
The primary endpoint was achieved in both groups. The treatment efficacy was 100% in all cases. At 1 and 6 months post-procedure, there was no significant difference in major adverse cardiovascular events, acute myocardial infarction, or stent thrombosis between the two groups.
IVUS-guided coronary intravascular lithotripsy is a safe and effective alternative to rotational atherectomy, potentially reducing certain complications.
本研究旨在比较血管内超声(IVUS)引导下冠状动脉血管内碎石术与旋磨术治疗严重冠状动脉钙化的疗效和安全性。
对2022年10月至2023年8月在宁夏医科大学总医院接受经皮冠状动脉介入治疗的60例患者进行回顾性分析。患者分为两组:30例接受IVUS引导下冠状动脉血管内碎石术,30例接受IVUS引导下旋磨术。主要终点包括心肌梗死溶栓治疗Ⅲ级血流及经皮冠状动脉介入治疗后狭窄<30%,以及IVUS指标,如支架扩张>80%、避免高斑块负荷或富含脂质的斑块、使贴壁不良最小化<0.4 mm/1 mm,以及预防组织脱垂和夹层。通过并发症以及术后1个月和6个月的主要不良心血管事件发生率评估安全性。
两组均达到主要终点。所有病例的治疗有效率均为100%。术后1个月和6个月,两组在主要不良心血管事件、急性心肌梗死或支架血栓形成方面无显著差异。
IVUS引导下冠状动脉血管内碎石术是旋磨术的一种安全有效的替代方法,可能会减少某些并发症。