真实世界单个中心的经验与软静脉移植干预:过器应该被过出来吗?
Adman Kassier1, Ronak Soni, Kameel Kassab
1Ascension Borgess Hospital, Michigan State University and Western Michigan University, 1521 Gull Rd, GOC 327, Kalamazoo, MI 49048. Adnan.kassier@gmail.com.
The Journal of invasive cardiology
|September 28, 2023
概括
博格斯协议,使用冠状内尼卡迪平和直接支架,为石静脉移植干预提供了对栓塞保护装置的有希望的替代方案,显示了有利的结果和减少了主要的不良心血管事件.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 沙芬静脉移植 (SVG) 皮肤冠状动脉干预 (PCI) 面临的挑战包括由于远端栓塞和血管收缩而导致的不回流和心肌损伤.
- 目前的指导方针推用于SVG PCI的栓塞保护装置 (EPD),但在许多研究中,它们的有效性都不够理想.
- 博格斯协议涉及预防性冠内尼卡迪平和直接支架,作为EPDs的替代品.
研究的目的:
- 评估Borgess协议的疗效和安全性,作为EPD的替代品,用于软静脉移植手术.
- 通过Borgess协议评估SVG干预后主要不良心血管事件 (MACE) 的发生率.
主要方法:
- 这是一项回顾性队列研究,涉及2017年至2021年间连续进行的424次SVG干预.
- 主要结局是30天的MACE,定义为死亡,新兴冠状动脉旁路移植手术,心肌梗塞或目标血管再血管化.
- 收集了关于遵守博格斯协议和使用冠状动脉内尼卡迪平的数据.
主要成果:
- 该研究包括424次SVG干预,其中76%呈现急性冠状动脉综合征.
- 在36%的病例中完全遵守了博格斯协议,在72%的病例中使用了冠心内尼卡迪平.
- 30天的MACE率为3.5%,主要是由心肌梗塞 (2,6%) 驱动的.
结论:
- 与使用EPD的SVGPCI策略相比,Borgess协议在SVG干预中显示出了有利的结果.
- 这种方法可以为管理复杂的SVG干预提供一个可行的替代方案.
- 进一步的研究是有必要的,承认这个单一中心,回顾性研究的局限性.
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