CTO-PCI 中初级 ADR 与救助 ADR 的比较分析

IF 1.6 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Lirui Yang, Tao Zhang, Gang Wang, Leisheng Ru, Lin Zhao
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引用次数: 0

摘要

目的比较慢性全闭塞(CTO)病变经皮冠状动脉介入治疗(PCI)过程中,原发性和救助性前向夹层和再入路(ADR)的效率和安全性。 方法:本研究纳入了接受 ADR 手术治疗 CTO 病变的患者,并根据 PCI 期间启动 ADR 的情况将其分为两组(主要 ADR 组和救助 ADR 组)。成功率和住院期间的主要心脑血管不良事件(MACCE)作为主要终点进行评估。手术时间、透视时间、导线穿越时间、辐射剂量和造影剂用量被视为次要终点。 结果:共有 243 名患者参与了这项研究,其中 127 名患者接受了主要 ADR,116 名患者接受了备用 ADR。两组患者的基线参数无差异。初级 ADR 组的成功率明显高于救助 ADR 组(分别为 89.0% 对 77.6%;P = 0.017)。两组的院内 MACCE 发生率均较低,无明显差异。与保外 ADR 组相比,原发性 ADR 组的手术时间、放射剂量和造影剂用量更少。Cox 回归分析显示,原发性 ADR 和 J-CTO 评分≥3 是 CTO-PCI 技术成功的独立预测因素。 结论:初级 ADR 和保外 ADR 都是 CTO-PCI 的安全策略。与保外ADR相比,原发性ADR能明显提高CTO PCI的成功率,手术时间更短、辐射剂量更低、造影剂用量更少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A Comparative Analysis of Primary and Bailout ADR in CTO-PCI

A Comparative Analysis of Primary and Bailout ADR in CTO-PCI

Objective: To compare the efficiency and safety of primary and bailout antegrade dissection and re-entry (ADR) during percutaneous coronary intervention (PCI) for chronic total occluded (CTO) lesions.

Methods: Patients who underwent ADR procedures for CTO lesions were enrolled in this study and were divided into two groups (primary ADR and bailout ADR) based on the initiation of ADR during PCI. The success rate and major adverse cardiovascular and cerebrovascular events (MACCE) during hospitalization were assessed as the primary endpoints. Procedure time, fluoroscopy time, wire crossing time, radiation dose, and contrast volume were considered as secondary endpoints.

Results: A total of 243 patients were enrolled in this study, with 127 patients receiving primary ADR and 116 receiving bailout ADR. No differences were found in baseline parameters between the two groups. The success rate was significantly higher in the primary ADR group compared to the bailout ADR group (89.0% versus 77.6%, respectively; p = 0.017). The incidence of in-hospital MACCE was low in both groups, with no significant differences observed between them. Procedure time, radiation dose, and contrast volume were lower in the primary ADR group compared to the bailout ADR group. Cox regression analysis revealed that primary ADR and J-CTO score ≥ 3 were independent predictors of technical success in CTO-PCI.

Conclusions: Both primary and bailout ADR are safe strategies for CTO-PCI. Primary ADR significantly improves the success rate of PCI for CTO compared to bailout ADR, with shorter operation time, lower radiation dose, and reduced contrast volume.

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来源期刊
Journal of interventional cardiology
Journal of interventional cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.80
自引率
0.00%
发文量
81
审稿时长
6-12 weeks
期刊介绍: Journal of Interventional Cardiology is a peer-reviewed, Open Access journal that provides a forum for cardiologists determined to stay current in the diagnosis, investigation, and management of patients with cardiovascular disease and its associated complications. The journal publishes original research articles, review articles, and clinical studies focusing on new procedures and techniques in all major subject areas in the field, including: Acute coronary syndrome Coronary disease Congenital heart diseases Myocardial infarction Peripheral arterial disease Valvular heart disease Cardiac hemodynamics and physiology Haemostasis and thrombosis
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