在CCS或NSTE-ACS患者中,单个会话与分阶段的多血管最佳IVUS引导PCI对比
Ko Yamamoto1, Hiroki Shiomi2, Takeshi Morimoto2
1Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
JACC. Asia
|August 24, 2023
概括
单个会话和分阶段的多血管静脉超声 (IVUS) 引导的皮肤冠状动脉干预 (PCI) 在患有慢性冠状动脉综合征或非ST升高急性冠状动脉综合征的患者中显示出类似的结果. 这项研究为最佳的PCI策略提供了有价值的见解.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 没有先前的研究比较了单次会议与分阶段的多血管IVUS引导PCI用于慢性或非ST升高的急性冠状动脉综合征.
- 血管内超声波 (IVUS) 对于在PCI期间优化支架扩张至关重要.
研究的目的:
- 在慢性冠状动脉综合征 (CCS) 或非ST升高急性冠状动脉综合征 (NSTE-ACS) 患者中,比较单次会议与分阶段的多血管IVUS引导PCI的临床结果.
主要方法:
- 一项前性多中心单臂试验 (OPTIVUS-Complex PCI研究) 招募了1021名接受IVUS指导的多血管PCI的患者.
- 患者被分为单次 (n=246) 或分阶段 (n=775) 的PCI组.
- 主要终点是死亡,心肌梗塞,中风或1年后任何冠状动脉再血管化的复合结果.
主要成果:
- 阶段性PCI更常见,并且与更复杂的冠状动脉解剖学有关 (例如,3血管疾病,慢性全闭).
- 两组之间PCI成功率,手术并发症和实现最佳支架扩张的情况都相似.
- 主要终点的1年累积发病率在单次会议 (9.0%) 和分阶段 (10.8%) PCI组之间没有显著差异 (P=0.42).
结论:
- 一次性和分阶段的多血管IVUS引导PCI在CCS或NSTE-ACS患者中显示了可比的1年临床结果.
- 单次治疗和分阶段PCI之间的选择可能取决于患者的复杂性和程序考虑,观察到类似的安全性和有效性.
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