| ObjectiveThe current research project is to analyze the efficacy and safety of combined percutaneous transluminal coronary atherectomy(PTCRA)in patients with severe coronary artery calcification(CAC).MethodsThe 120 patients with coronary heart disease were divided into three groups,namely,non-calcification group(30 cases),mild and moderate calcification group(30 cases),and severe calcification group(60cases).Coronary angiography was used to analyze the number,location and type of lesions in patients with non-calcification,mild/moderate calcification and severe calcification.Patients in the severe calcification group were treated with percutaneous endoscopy combined with stent implantation as a follow-up study.Patients in the severe calcification group were divided into the interventional group(30 cases received percutaneous endoscopy combined with stent implantation)and the conservative group(30 cases received conventional drug therapy).Coronary angiography was used for the treatment of transdermal rotary grinding combined with stent implantation.The rotary grinding head was sent to the proximal end of the narrow target vessel at a low speed of 5000 RPM under the guidance of the finger guide wire,and thenpecked at a high speed of 140,000 ~ 160,000 RPM,and then put into the drug-eluting artery stent after rotary grinding.The follow-up of patients during and after operation and the occurrence of Major adverse cardiovascular and vascular events(MACCE)and angina in each group were recorded.Results(1)biochemical test results of patients’ basic information and arteriosclerosis related indicators: there were no statistically significant differences in gender,age,smoking history,disease history,clinical blood lipid,uric acid,creatinine and other biochemical indicators,p>0.05.(2)Vascular calcification: non-calcified group and the mild/moderate calcification group were mainly single-vessel disease,and most of them were localized lesions,whereas the severe calcification group were mostly double-or multi-vessel lesions,and most of them were tubular or diffuse long lesions.(3)Results: Compared with the conservative group,left ventricular end-diastolic diameter and left ventricular ejection fraction were significantly improved after half a year in the interventional combined with percutaneous coronary rotation(P <0.05).During follow-up,angina,myocardial infarction and cardiac death were significantly lower in the intervention group than in the conservative group(P <0.05).Conclusions1.Different manifestations of coronary artery calcification.In patients with non-calcification and mild/moderate coronary calcification,the lesions were mainly single branch lesions and mostly localized lesions.The patients with severe coronary calcification lesions were mostly double or multiple branches,and the lesions were mostly tubular or diffuse long lesions.2.Interventional combined with percutaneous coronary rotary grinding improves left ventricular end-diastolic diameter and left ventricular ejection fraction better than conservative drug therapy,and reduces postoperative MACCE. |
