Influence of intravascular ultrasound on the prognosis of patients after rotational atherectomy
10.16571/j.cnki.1008-8199.2020.06.011
- VernacularTitle: 血管内超声引导下行冠状动脉旋磨术对患者预后的影响
- Author:
Zhan-ru QI
1
;
Zhong-hai WEI
1
;
Jing-mei ZHANG
2
;
Qing DAI
1
;
Jun XIE
1
;
Kun WANG
1
;
Li-na KANG
2
;
Lian WANG
1
;
Jie SONG
1
Author Information
1. Department of Cardiology, Nanjing Medical University Drum Tower Clinical Medical School, Nanjing 210008, Jiangsu, China
2. Department of Cardiology, Yizheng Hospital, Yizheng 211900, Jiangsu, China
- Publication Type:Journal Article
- Keywords:
intravascular ultrasound;
coronary rotational atherectomy;
calcification
- From:
Journal of Medical Postgraduates
2020;33(6):613-617
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThe development of new endovascular imaging techniques has optimized surgical treatment strategies. In this paper, we investigated the effect of rotational atherectomy (RA) guided by intravascular ultrasound (IVUS) on long-term postoperative follow-ups.MethodsClinical data of 211 patients who underwent RA in the Department of Cardiology, Nanjing Drum Tower Hospital from November 2011 to December 2018 were retrospectively analyzed, and they were divided into IVUS Group (116 patients) and Non-IVUS Group (95 patients) according to whether they underwent the guidance of intravascular ultrasound or not. Basic information of all patients, coronary artery lesions and details of operation and other clinical data were collected. The long-term prognosis of the patients was collected and compared by telephone or outpatient follow-ups.ResultsThe head diameter, average stent diameter and total hospitalization expenses of the IVUS Group were significantly higher than those of the Non-IVUS Group, and the differences were statistically significant [(1.53±0.19) mm vs (1.46±0.14) mm, P=0.001; (3.09±0.48) mm vs (2.87±0.30) mm, P<0.001; (57,300±18,300) yuan vs (49,300±16,600) yuan, P=0.001]. The all-cause case fatality rate and cardiogenic case fatality rate of the IVUS Group were lower than those of the Non-IVUS Group (7.5% vs 16.7%, P=0.048; 1.9% vs 11.9%, P=0.005); There were no significant differences in the incidence of long-term major adverse cardiovascular events (MACE), myocardial infarction, target vessel revascularization and non-fatal stroke between the two groups (P>0.05). Multivariate COX regression analysis showed that the cardiogenic mortality was significantly reduced in the IVUS Group (HR=0.10, 95%CI: 0.02~0.63, P=0.014), but there was no statistically significant difference between the two groups in the incidence of all-cause death and long-term MACE (P>0.05).ConclusionCompared with the Non-IVUS Group, IVUS-guided RA can significantly reduce the incidence of long-term cardiogenic death and total hospitalization expenses.
