目的 回顾性分析泰达国际心血管医院心内科行冠状动脉旋磨术(rotational atherectomy,RA)联合药物洗脱支架(drug-eluting stents,DES)置入术治疗的患者临床资料,评估RA的安全性及预后.方法 连续入选2012年9月至 2015 年9月泰达国际心血管病医院心内科行RA联合DES置入术治疗的患者共60例65处病变,分析冠状动脉造影(coronary angiography,CAG)资料,收集临床信息,并通过门诊及电话随访评估其预后.结果 60例患者65处病变中成功完成RA并置入DES共62处病变(95.3%),术后狭窄程度由(90.7±6.2)%降至(19.5±6.6)%,术中发生并发症4例(6.7%),经处理均取得较好效果.60例患者中59例完成随访,平均随访时间为(23.3±10.6)个月,1例患者术后10个月发生支架内再狭窄;1例患者术后16个月支架内血栓形成;1例患者术后7个月发生急性心肌梗死;2例患者分别于术后14个月、17个月猝死,考虑为心源性死亡.结论 RA联合DES置入术治疗冠状动脉严重钙化病变手术成功率较高,且具有较高的安全性和良好预后.%Objective Clinical data of patients who received rotational atherectomy (RA) combined with drug-eluting stent implantation (DES) in TEDA International Cardiovascular Hospital were retrospectively analyzed to evaluate it's safety,short-term and long-term prognosis.Methods A total of 60 patients who underwent RA were consecutively enrolled in the study in TEDA International Cardiovascular Hospital from September 2012 to September 2015.Pre and post procedure coronary angiography and clinical information were collected.Long term outcomes were obtained by outpatient clinical follow-up or telephone interview.We analysed angiographic data.Results Among 60 patients with 65 lesions,RA combined with drug-eluting stent implantation was successful performed in 62(95.3%) lesions and postoperative stenosis degree drop from (90.7±6.2)% to (19.5±6.6)%.4 cases(6.7%)developed complications and were treated accordingly during procedure with satisfactory results.Overall incidence of in-hospital MACCE was 1.7% with one case (1.7%) of myocardial infarction.The mean follow-up time was (23.3±10.6) months.In stent restenosis occurred in 1 case(1.7%) 10 months after operation.Stent thrombosis occurred in 1 case(1.7%) 16 months after operation and myocardial infarction (MI) occurred in 1 case(1.7%) 7 months after operation.One patient died 14 months after operation and another patient died 17 months after operation.Both of them were considered as cardiac death.There was no mortality of other causes recorded.Long-term MACCE was 9.5% and TLR is 5.1%.Conclusions Rotational atherectomy combined with DES implantation in the treatment of severe coronary artery calcification lesions has high success rate, good safety profile and good short and long-term prognosis.
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