浙江医学2018，Vol.40Issue(3)：243-247,5.DOI:10.12056/j.issn.1006-2785.2017.40.3.2017-2370
血管内超声指导下冠状动脉支架术后即刻支架膨胀不全相关危险因素分析
Risk factors of stent underexpansion in intravascular ultrasound-guided percutaneous coronary intervention
摘要
Abstract
Objective To investigate the risk factors of stent underexpansion in intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI).Methods The clinical data,angiographic and pre-,post-PCI IVUS findings of 102 patients (102 lesions) were reviewed.According to the stent expansion index ≥ median or ＜median,the patients were stratified as stent adequate expansion group (88.9 ± 8.0％) and stent underexpansion group (66.2 ± 8.8％).The clinical features of two groups were compared and the risk factors of stent underexpansion was analyzed.Results There were no significant differences in the baseline characteristics between these two groups.Compared with stent adequate expansion patients,the patients with stent underexpansion had more calcified lesions from both angiographic findings (37.3％ vs 17.7％,P＜0.05) and IVUS measurement (76.5％ vs 56.9％,P＜0.05),larger maximum arc of superficial calcium [85° (26°,120°)vs 28 (0°,102°),P＜0.05],longer lesion length[(38.5 ± 10.1)mm vs (30.1 ± 11.4)mm,P＜0.01)],and smaller minimum stent area [(6.0 ± 1.9)mm2 vs (7.7 ± 2.2)mm2,P＜0.01].Multivariate logistic regression analysis revealed that maximum arcof superficial calcium (OR=1.21,95％ CI:1.02-1.44,P＜0.05) and lesion length(OR=1.51,95％ CI:1.12～2.04,P＜0.01) were independently associated with stent underexpansion.By receiver-operating characteristic (ROC) analysis,the area under curve (AUC) was 0.643 for the maximum arc of superficial calcium and 0.715 for the lesion length.The cut-off values for predicting stent underexpansion were 80° and 32.0 mm,respectively (P＜0.01).Conclusion Stent underexpansion phenomena is not uncommon,despite adjunctive post-dilatation with noncompliant balloon.Extent of superficial calcium and lesion length are the strongest determinants of stent underexpansion.关键词
冠状动脉疾病/药物洗脱支架/冠状动脉介入/血管内超声Key words
Coronary artery diseases/ Drug eluting stents/ Percutaneous coronary intervention/ Intravascular ultrasound引用本文复制引用
单培仁,蔡雪黎,项光泽,周昌钻,胡龙,黄伟剑..血管内超声指导下冠状动脉支架术后即刻支架膨胀不全相关危险因素分析[J].浙江医学,2018,40(3):243-247,5.基金项目
温州市科技局项目(Y20160307) （Y20160307）
国家自然科学青年基金项目(81600341) （81600341）
浙江省自然青年基金(LQ15H020005) （LQ15H020005）
