Objective To compare the values of balloon inching dilatation and buddy wire technique in treatment of chronic total occlusion(CTO) of coronary arteries.Methods Seventy-four patients with CTO of coronary arteries were treated with either balloon inching dilatation(observation group,n =30) or traditional buddy wire technique (control group,n =44).The surgical success rate,X-ray exposure time,operation time,contrast agent dosage,complications and adverse cardiac events were compared between two groups.Results The surgical success rate in observation group was significantly higher than that in control group(96.66％ vs 77.27％,P＜0.05).Furthermore,compared with control group,X-ray exposure time,operation time and contrast agent dosage were significantly reduced in observational group(P＜0.05).Except one patient with cardiac shock in control group(discharge from hospital after timely rescue),both groups had no postoperative complications and adverse cardiac events,such as myocardial infarction,acute or subacute thrombosis,ventricular fibrillation,pulmonary edema,coronary artery bypass graft,cardiac shock,cardiac death,and cardiovascular events.Conclusion When the balloon is difficult to pass through the CTO of coronary arteries,balloon inching dilatation can increase high surgical success rate,shorten operation time and X-ray exposure time,and reduce surgery costs.Therefore,balloon inching dilatation is a feasible,safe and effective treatment for CTO of coronary arteries.%目的 对比球囊寸进冲击扩张法与传统的双导丝法开通冠状动脉慢性完全闭塞(CTO)病变的价值.方法 选取74例冠状动脉慢性完全闭塞患者,按手术操作方法不同分为球囊寸进冲击扩张法开通CTO病变组(观察组,n=30)及传统双导丝法开通CTO病变组(对照组,n=44),比较2组手术成功率、X线曝光时间、手术时间、造影剂用量、并发症及心脏不良事件.结果 观察组经皮冠状动脉介入治疗(PCI)成功率为96.66％,高于对照组的77.27％ (P＜0.05),且手术时间、X线曝光时间、造影剂用量明显少于对照组(P＜0.05).除对照组1例患者出现心源性休克(经及时抢救好转出院)以外,2组未见急性心肌梗死、急性或亚急性血栓、心室颤动、肺水肿、冠状动脉搭桥术、心源性休克、心源性死亡等心血管事件发生.结论 当导丝通过病变而球囊难以通过CTO病变时,应用球囊寸进冲击扩张法,手术成功率高,手术时间短,X线曝光时间短,在一定程度上减少了手术费用.应用球囊寸进冲击扩张法可行且安全,是开通CTO病变的一种有效方法.
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