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目的探讨血管内超声(IVUS)指导药物洗脱支架置入的价值。方法对38例急性冠状动脉综合征患者67处病变行IVUS检查,指导药物洗脱支架置入。置入后再行IVUS,对未达到理想释放者进行高压球囊后扩张。观察6个月主要不良心脏事件。结果首次常规高压扩张置入支架,67处病变均达到冠状动脉造影理想标准,但符合IVUS理想标准仅40处(59.7%),27处(40.3%)未达标;行高压球囊后扩张,又有21处达到IVUS理想标准。最终达到IVUS理想标准者与常规高压扩张后比较,差异有统计学意义(91.0%对59.7%,P<0.0001)。随访期间无一例心源性死亡或再梗死,再发心绞痛2例(5.3%)。结论常规高压球囊扩张置入药物洗脱支架,并不能使所有支架达到IVUS理想标准。IVUS指导下高压球囊后扩张可进一步改善药物洗脱支架置入效果,具有重要临床价值。
Objective To investigate the value of intravascular ultrasound (IVUS) guided drug-eluting stents. Methods Thirty-seven patients with acute coronary syndrome (ACS) were enrolled in this study. IVUS after implantation, after the high pressure balloon did not reach the ideal release of those who dilate. Six months of major adverse cardiac events were observed. Results The first routine high-pressure dilatation was placed in the stent. All 67 lesions achieved the ideal standard of coronary angiography, but only 40 (59.7%) and 27 (40.3%) did not meet the IVUS ideal standard. There are 21 to IVUS ideal standard. Those who eventually achieved the IVUS ideal standard had statistically significant differences (91.0% vs 59.7%, P <0.0001) compared with those after conventional high pressure dilatation. During follow-up, there was no cardiac death or reinfarction, and angina pectoris was recurred in 2 cases (5.3%). Conclusion Conventional high-pressure balloon dilatation into drug-eluting stents does not render all stents to the IVUS ideal. IVUS-guided high-pressure balloon dilatation can further improve the effect of drug-eluting stents, has important clinical value.