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目的 :探讨小冠状动脉 (直径 <3 mm)狭窄性病变实施普通球囊、切割球囊或小支架介入治疗的疗效和并发症。方法 :小冠脉狭窄性病变介入治疗 (PCI)患者 13 6(男 87,女 49)例 ,年龄 3 2～ 85(54± 17)岁。根据手术方法分为普通球囊组、切割球囊组和小支架组。残余狭窄率 <3 0 %且无动脉夹层、撕裂等并发症者为手术成功 ,术后 6个月复查冠脉造影。结果 :普通球囊组 3 2例 ,手术成功 2 6例 (81% ) ,出现动脉夹层或扩张不满意改支架术 6例 (2 4% )。切割球囊组 48例 ,手术成功 43例 (90 % ) ,出现动脉夹层或扩张不满意改支架术 3例 ,出现造影剂血管外漏 2例。支架组 56例 ,手术成功 53例 (95% ) ,出现造影剂血管外漏 2例 ,出现心包填塞抢救成功 1例。3组均未出现血管急性闭塞。术后 6个月 ,切割球囊组、小支架组、普通球囊组冠脉造影狭窄率分别为 2 3 % (11例 )、16% (9例 )、3 8% (12例 )。结论 :小冠脉狭窄性病变实施介入治疗能取得显著效果 ,小支架术优于普通球囊扩张术 ,切割球囊扩张与普通球囊扩张具有近似疗效
Objective: To investigate the curative effect and complications of small coronary artery (diameter <3 mm) stenosis in interventional therapy of common balloon, cutting balloon or small stent. Methods Thirteen (87 males and 49 females) patients with small coronary artery stenosis were enrolled in this study. Their ages ranged from 32 to 85 years (54 ± 17 years). According to surgical methods are divided into ordinary balloon group, cutting balloon group and small stent group. Residual stenosis <30% and no complications, such as dissection and tear, were successfully performed and coronary angiography was reviewed 6 months after surgery. Results: In the common balloon group, 32 cases were successful, 26 cases were successful (81%), and 6 cases (24%) were unsatisfactory with stent or dilatation. Forty-eight patients underwent balloon ablation, 43 cases (90%) were successful in operation, 3 cases were not satisfied with stent dissection or dilatation, and 2 cases showed vascular leakage of contrast agent. In the stent group, 56 cases were successful, 53 cases were successful (95%), 2 cases of vascular leakage of contrast agent occurred, and 1 case of cardiac tamponade and rescue was successful. No acute vascular occlusion occurred in all three groups. At 6 months after operation, the stenosis rates of coronary angiography were 11%, 16% (9 cases) and 38% (12 cases) in the cutting balloon group, the small stent group and the common balloon group respectively. Conclusions: The interventional treatment of stenosis of small coronary artery can achieve significant effect. The small stent is better than the common balloon dilatation. The effect of cutting balloon dilation is similar to that of common balloon dilatation