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目的 :采用血管腔内超声 (IVUS)研究经皮冠状动脉 (冠脉 )内FXminiRAILTM球囊成形术 (FXBA)治疗冠脉支架内再狭窄 (ISR)的疗效及其安全性。方法 :冠脉内支架植入术后单支ISR >70 %的病人 171例 (男性 12 4例 ,女性 4 7例 ,年龄 6 1± 11岁 ) ,分为FXBA组 (n =10 6 )和普通球囊成形术 (PTCA)组 (n =6 5 )。所有病例术前、术后即刻以及术后随访期行定量冠脉造影 (QCA)及IVUS。QCA分析病变长度 ,最小管腔直径 (MLD) ,参照管腔直径 (RLD)和管腔直径狭窄百分比 (DS) ;IVUS分析血管总横截面积 (TVA) ,外弹力膜内横截面积 (EEMA) ,支架横截面积 (SA) ,最小管腔横截面积 (MLA) ,支架内的再狭窄面积(RA)。随访靶血管再次成形率 (TVR)和主要不良心血管事件 (MACE)发生率。结果 :FXBA治疗ISR和PTCA一样易于操作 ,两组的操作成功率均为 10 0 %。IVUS显示FXBA组治疗ISR后即刻管腔面积的获得大于PTCA组 (5 .4 3± 0 .6 3mm2 对4 .92± 0 .4 6mm2 ,P <0 .0 5 ) ,而随访期 (平均随访时间 5 .4± 1.6个月 )管腔面积的丢失则小于PTCA组 (0 .5 1± 0 .2 1mm2 对0 .91± 0 .2 3mm2 ,P <0 .0 5 ) ;两组术后即刻SA均较术前增加。随访期FXBA组的ISR复发率 (2 1.1%± 7.6 % )明显低于PT CA组 (38.3%± 4 .3% ) ,P <0 .0 0 1;FXBA
Objective: To study the efficacy and safety of percutaneous transluminal coronary angioplasty (FXBA) in the treatment of coronary stent restenosis (ISR) with intravascular ultrasound (IVUS). Methods: A total of 171 patients (122 males and 47 females, age 61 ± 11 years) with single ISR> 70% after coronary stenting were randomly divided into two groups: group FXBA (n = 106) Common balloon angioplasty (PTCA) group (n = 65). All patients underwent coronary angiography (QCA) and IVUS immediately before surgery, immediately after surgery, and after follow-up. QCA analysis of lesion length, minimum luminal diameter (MLD), reference lumen diameter (RLD) and lumen diameter stenosis percentage (DS); IVUS analysis of total vascular cross-sectional area (TVA), outer elastic membrane cross-sectional area ), Stent cross-sectional area (SA), minimal lumen cross-sectional area (MLA), and stent restenosis area (RA). Follow-up target vessel reshaping rate (TVR) and major adverse cardiac events (MACE) incidence. Results: The treatment of ISR with FXBA was as easy to operate as PTCA with a success rate of 100% in both groups. IVUS showed that the lumen area of FXBA group was significantly longer than that of PTCA group (5.34 ± 0.663mm2 vs 4.92 ± 0.464mm2, P <0.05), and the follow-up period (mean follow-up Time was 4.5 ± 1.6 months), the loss of lumen area was less than that of PTCA group (0. 51 ± 0. 21mm2 vs 0 .91 ± 0. 23mm2, P <0. 05) Immediate SA increased compared with preoperative. The recurrence rate of ISR in FXBA group was significantly lower than that in PT CA group (38.3% ± 4. 3%, P <0.01) at the follow-up period (21.1% ± 7.6%