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顺应性球囊与非顺应性球囊。一项前瞻性随机研究。

Compliant vs non-compliant balloons. A prospective randomized study.

作者信息

Seyithanoglu B Y, Zaki Masud A R, Ergene O, Morris W M, Kozan O, Corbelli J C, Wilson M F

机构信息

Dokuz Eylül University Medical Faculty Hospital, Izmir, Turkey.

出版信息

Jpn Heart J. 1998 Jan;39(1):45-54. doi: 10.1536/ihj.39.45.

Abstract

In this prospective randomized trial we explored the possibility of different procedural outcomes with regard to compliant (polyolefin copolymer (POC)), and non-compliant (polyethylene terapthelate (PET)) balloon materials commonly used during percutaneous transluminal coronary angioplasty (PTCA). For this purpose, 51 female and 149 male (total 200) patients were randomized to 100 compliant and 100 non-compliant balloons. Only single lesions were included in the study and patients who had PTCA for more than one lesion in different segments at different sessions were each entered separately (there were actually 49 female and 143 male patients). PTCA procedures were performed in conjunction with quantitative coronary angiographic techniques and the films were reviewed by two investigators in a blinded fashion. Statistical analysis for various procedural end-points were performed by non-paired Student t test with statistical significance being p < 0.05. There were no differences in demographic and clinical characteristics between groups. Lesion characteristics of both groups were exactly matching for vessel size, balloon size, balloon vessel ratio, minimal luminal diameter and percent stenosis of the index lesion. Similarly, minimal residual diameter, percent residual stenosis, net gain, densitometric net area gain, and maximum pressure (2.2 +/- 5 mm vs 2.1 +/- 0.6 mm, 18 +/- 17% vs 23 +/- 15%, 0.8 +/- 0.5 mm vs 0.8 +/- 0.6 mm, 48 +/- 25% vs 48 +/- 26%, 7.3 +/- 2 atm. vs 6.8 +/- 3 atm., respectively) values were not statistically different between compliant and non-compliant balloon groups. Major in-hospital complications, dissections caused by the study balloon (mostly type A and B), crossover and bail-out procedures (5 vs 3, 34 vs 32, 4 vs 3, 13 vs 14, respectively) were similar for both compliant and non-compliant balloon groups. Study balloon success rate (defined as < 50% residual stenosis or > 20% net gain in the absence of major in-hospital complications, crossovers and bail-outs) and overall procedural success rate (80% vs 74%, 90% vs 85%) were not statistically different for compliant and non-compliant balloons. In conclusion, we did not observe any statistically significant difference between compliant and non-compliant balloons in terms of immediate procedural results.

摘要

在这项前瞻性随机试验中,我们探讨了在经皮腔内冠状动脉成形术(PTCA)期间使用的顺应性(聚烯烃共聚物(POC))和非顺应性(聚对苯二甲酸乙二酯(PET))球囊材料产生不同手术结果的可能性。为此,将51名女性和149名男性(共200名)患者随机分为100个顺应性球囊组和100个非顺应性球囊组。研究仅纳入单一病变,在不同时段对不同节段的多个病变进行PTCA的患者分别纳入(实际上有49名女性和143名男性患者)。PTCA手术结合定量冠状动脉造影技术进行,影片由两名研究人员以盲法进行评估。对各种手术终点进行非配对学生t检验,统计学显著性为p < 0.05。两组之间的人口统计学和临床特征无差异。两组病变特征在血管大小、球囊大小、球囊血管比、最小管腔直径和靶病变狭窄百分比方面完全匹配。同样,顺应性和非顺应性球囊组之间的最小残余直径、残余狭窄百分比、净增益、密度计净面积增益和最大压力(分别为2.2 +/- 5毫米对2.1 +/- 0.6毫米、18 +/- 17%对23 +/- 15%、0.8 +/- 0.5毫米对0.8 +/- 0.6毫米、48 +/- 25%对48 +/- 26%、7.3 +/- 2个大气压对6.8 +/- 3个大气压)值无统计学差异。顺应性和非顺应性球囊组的主要院内并发症、研究球囊引起的夹层(大多为A型和B型)、交叉和补救手术(分别为5对3、34对32、4对3、13对14)相似。研究球囊成功率(定义为在无主要院内并发症、交叉和补救的情况下残余狭窄< 50%或净增益> 20%)和总体手术成功率(80%对74%、90%对85%)在顺应性和非顺应性球囊之间无统计学差异。总之,就即刻手术结果而言,我们未观察到顺应性和非顺应性球囊之间存在任何统计学显著差异。

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