| Objectives The research aims at providing a scientific basis for improving the PCI strategy against long coronary artery lesions / calcification lesions by observing if the application of intravascular ultrasound(IVUS)can reduce the incidence of MACEs after stent implantation in patients with coronary artery lesions.Methods From September,2014 to June,2016,a total of 100 patients with long coronary artery lesions and slight / mild calcification lesions of Tangshan Worker’s Hospital who accepted coronary angiogram(CAG)were selected as the study subject.52 of these patients aged 45-78(57.31 ± 9.87)years old,who would take both IVUS and stent implantation,were served as study group;while the other 42 patients aged 43-79(60.25 ±10.12)years old,who would only take CAG and stent implantation,were treated as control group.An informed consent was provided to all the patients and the patients’ information was recorded in detail.The information includes: 1.General information: age,gender,height,weight,smoking history,drinking history,genetic history;2.High risk factors:hypertension,type Ⅱ diabetes,high blood lipids,etc.(to see whether the two groups are comparable);3.The data of the patients undergoing CAG: the minimum blood vessel diameter(MLD),diameter stenosis rate(DS%),lesion length(LL)at atherosclerotic plaque,and the calcification at the lesion and the post-Stent situation.4 The data of the patients undergoing IVUS: the minimum blood vessel diameter(MLD),diameter stenosis rate(DS%),area stenosis rate(AS%),lesion length(LL),the shape of the lesion,the type,nature and composition of the plaque,and the placement of the stent(whether the stent was poorly adhered,the stent dilation was insufficient,Vascular wall hematoma,etc.)after the stent implantation was guided by IVUS.5.The main cardiac events in 30 days and 1 year after stent implantation,including cardiac death,recurrent angina,nonfatal myocardial infarction,and revascularization.Statistical analysis was performed using SPSS 17.0.The basic information of two groups of patients(i.e.,age and body mass index)obeyed normal distribution and was described with the mean ± standard deviation((?) ± s),which was compared by using the t-test.The count data(e.g.,gender)of the two groups was expressed as a percentage(%),which were analysed by x~2 test or Fisher’s exact test.The difference is statistically significant with P <0.05.Results 1.There was no statistically significant difference between the general data(gender,age),clinical data(prevalence of hypertension,type Ⅱ diabetes mellitus,blood lipid level),lesion(lesion length and calcification),lesion(anterior descending branch,ACEI / ARB,etc.)of the two groups.The two group are comparable.2.Postoperative fellow-ups were performed on the patient(including 48 patients in the control group and52 patients in the IVUS group)in the 1st month and 1st year.The fellow-up in the 1st month showed that the incidence of MACEs among the study group was slightly lower than that among the control group(6.25%),however the difference was not statistically significant.While the fellow-up for the 1st year indicated the incidence of MACEs was lower in the study group than in the control group postoperatively(17.31% vs 39.58%),and the difference was statistically significant.Conclusions 1.For patients with long coronary artery lesion lesions,experienced surgeons can develop exams by combing CAG and IVUS.Observing the stent placement,with or without edge dissection,adherence,etc.,and promoting corrections in time using IVUS can significantly reduce the incidence of major cardiovascular events(MACEs) within 1 year after stent implantation.2.The target vascular lesions measured by IVUS are slightly longer than the counterpart of CAG.Additionally,the calcification tested by IVUS is also slightly heavier than that by CAG.Hence,the combination with IVUS can provide accuracy information of lesions than only using CAG,which can be used for the guidance of the PCI. |
PDF Full Text Request