肝素逆转用于冠状动脉穿孔
Yuichi Sawayama1,2, Kenta Sasaki1, Narumi Taninobu1
1Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan.
概括
在冠状动脉穿孔 (CAP) 的穿皮冠状动脉干预 (PCI) 期间逆转肝素有助于血液静止,但如果设备仍然存在,则存在血栓形成的风险. 肝素逆转改善了血液静止,但当激活凝固时间较低时,血栓形成风险增加.
科学领域:
- 干预心脏病学 干预心脏病学
- 血管医学 血管医学
- 心血管外科心血管外科
背景情况:
- 穿皮冠状动脉干预 (PCI) 期间冠状动脉穿孔 (CAP) 是一个严重的并发症.
- 肝素逆转用于静血,但存在血栓形成的风险,特别是在内置设备.
研究的目的:
- 评估氨酸逆转对CAP患者和部署的冠心器装置的结果的影响.
- 在这种特定的临床场景中评估肝素逆转的安全性和有效性.
主要方法:
- 在PCI期间 (2006年1月至2023年10月) 对CAP案件的回顾性分析.
- 患者的分层是基于氨酸逆转是否在现场使用冠状动脉器件进行的.
- 结果包括冠状动脉血栓形成,成功的血静,以及全因死亡率.
主要成果:
- 在PCI案件中,CAP发生在1.6%的案例中.
- 在57%的CAP患者中,使用装置进行了氨酸逆转.
- 冠状动脉血栓发生在7.6%的肝素逆转和装置患者中.
- 低激活凝血时间 (ACT <150秒) 与血栓形成相关.
- 肝素逆转与成功的静血 (91%对73%) 相关,但与死亡率无关.
结论:
- 在内置装置的CAP患者中,肝素逆转会增加冠状动脉血栓形成的风险,特别是在ACT<150秒的情况下.
- 虽然没有显著影响死亡率,但肝素逆转改善了静血率.
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