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目的 评价静脉桥血管经皮冠状动脉介入治疗及支架治疗后的早期临床结果。方法对 64例 91处大隐静脉桥血管病变行介入治疗,将术中及住院期间的临床结果和术中应用的其他介入治疗辅助装置一并录入数据库并进行分析。结果 手术成功率 95. 3%;术中发生非Q波心肌梗死1例(1. 6% )。一过性无再流现象 4例(6. 3% ),其中 1例置入支架后无再流而出现室颤,经电除颤、心脏按压、气管插管及置入主动脉内气囊反搏装置后血流恢复正常。应用血管远端保护装置 7例(10. 9% ),X sizer取栓系统 4例;术中或术后应用血小板GPⅡb/Ⅲa受体拮抗剂 25例 (39. 1% )。住院期共发生非Q波心肌梗死 2例,主要心脏不良事件发生率为 3. 1%。结论 静脉桥血管的经皮冠状动脉介入加支架治疗的即刻成功率高,近期临床效果满意,中、远期结果有待进一步随访;血管远端保护装置和血小板受体拮抗剂的应用有可能改善预后。
Objective To evaluate the early clinical results of percutaneous coronary intervention (PCI) and stent treatment of venous bridge. Methods 64 cases of 91 saphenous vein grafts were treated with interventional therapy. The intraoperative and in-hospital clinical results and other interventional therapeutic aids for intraoperative use were recorded in the database and analyzed. Results The success rate of surgery was 95.3%. One case (1.6%) of non-Q-wave myocardial infarction occurred during operation. One case had no reflow phenomenon in 4 cases (6.3%). One case had ventricular fibrillation after no stent implantation. After defibrillation, cardiac compression, endotracheal intubation and intra-aortic balloon catheterization Blood flow back to normal after stroke device. Application of vascular distal protection device in 7 cases (10.9%), X sizer tethering system in 4 cases; intraoperative or postoperative application of platelet GP Ⅱ b / Ⅲ a receptor antagonist in 25 cases (39.1%). 2 cases of non-Q wave myocardial infarction occurred during hospitalization, the incidence of major cardiac adverse events was 3.1%. Conclusion The immediate success rate of percutaneous coronary intervention and stent treatment of venous bridging vessels is high, and the clinical effect is satisfactory in the near future. The outcome of mid and long term follow-up is still to be followed up. The application of vascular distal protection device and platelet receptor antagonist may improve the prognosis .