药物涂层气球血管整形在接受复杂皮肤冠状动脉干预的患者中
Hyun Sung Joh1, Woochan Kwon2, Doosup Shin3
1Department of Internal Medicine and Cardiovascular Center, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
药物涂层气球 (DCB) 穿皮冠状动脉干预 (PCI) 在复杂的冠状动脉病变中显示出与药物释放支架 (DES) 单独的PCI相比的安全性和有效性. 对于复杂的PCI案件,DCB提供了一个可行的替代方案.
科学领域:
- 干预心脏病学 干预心脏病学
- 心血管器械 心血管器械
- 临床试验 临床试验
背景情况:
- 有限的临床数据存在,比较基于药物涂层气球 (DCB) 的皮肤冠状动脉干预 (PCI) 与仅用于复杂冠状动脉病变的药物排泄支架 (DES) 的PCI.
- 复杂的冠状动脉病变在PCI程序中存在独特的挑战.
研究的目的:
- 在患有复杂冠状动脉病变的患者中,评估基于DCB的PCI与仅DES的PCI相比的有效性和安全性.
- 作为主要终点,评估2年后目标船舶故障率 (TVF).
主要方法:
- 一项使用机构登记的新发症冠状动脉复杂病变患者的比较研究.
- 126名接受DCB基PCI治疗的患者的倾向性得分与234名仅接受DES治疗的患者的倾向性得分相匹配.
- 复杂的病变包括分叉,慢性全闭,未受保护的左主病,长病变 (≥38毫米),多血管疾病,需要≥3个装置的病变或严重化.
主要成果:
- 在DCB和DES组之间,基线特征是可比的.
- 基于DCB的PCI显示TVF的风险与基于DES的PCI相比相当 (7.6%对8.1%,P=0.638).
- 特定的TVF组件,包括心脏死亡,与目标血管相关的心肌梗塞和目标血管再血管化,也在两组之间是可比的.
结论:
- 在患有复杂冠状动脉病变的患者中,基于DCB的PCI表明TVF的风险与仅DES的PCI相比较.
- 对于接受复杂PCI的患者来说,DCB可以被认为是DES的合适替代装置.
- 进一步的研究可能会探索长期的结果和预后因素.
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