| Objective:To study the effectiveness and safety of the paclitaxel coating balloon after the treatment of the patients with coronary in-stent restenosis lesions.Methods:To screen patients of 31 cases strictly with the inclusion criterion and exclusion criterion for the patients,prompted by coronary angiography examination of in-stent restenosis in patients,adopt paclitaxel drug-coated balloon(SeQuent Please)to handle the restenosis lesions,and 9-12 months after adopt coronary angiography examination to review,from May 2015 to December 2015 in the people's hospital of Liaoning province.Collected the clinical data with the degree of vascular stenosis and minimum diameter when the time of preoperative,postoperative,and imaging review.Appling the statistical software of SPSS 13.0 to statisticial analysis,comparing and summarizing the patients use of paclitaxel drug-coated balloon for treatment of coronary in-stent restenosis for interventional treatment success rate of in-stent restenosis,late lumen loss situation lesions within the section.And comparing with a lot of multicenter study.RESULTS:The 33 patients were selected by the experiment in ordinary balloon pre expansion process smooth,that does not appear affect blood flow of interlayer,and with the drug-coated balloon in the treatment of in-stent restenosis lesion smoothly,drug-coated balloon expansion continues to 49 ± 3 seconds in all lesions,the success rate of immediate intervention operation was 100%,the duration of hospital stay has no adverse cardiovascular events,all patients were given 3 months of dual antiplatelet therapy after the intervention operation.During 9-12 months after surgery,a total of 32 people attended the review and the imaging follow-up rate was 97%(32/33),a 71-year-old male patient for diagnosis of lung tumor,refused to take coronary angiography examination.In the 32 patients with coronary angiography review,a 42-year-old male patient with angina symptoms during 10 months postoperatively,in our review of imaging,found recurrence of in-stent restenosis,the heaviest narrow over 90%,giving implantation DES treatment,and we have Ticagrelor instead of the antiplatelet drug,no recurrence of angina symptoms.The rest of the 31 patients with imaging review stent not seen obvious restenosis,and no recurrence angina symptoms.Preoperative compared postoperative pathological changes with lesions stenosis degree,postoperative and preoperative patients with lesions stenosis degree was statistically difference[11.0 ± 5.4%vs.77.6± 8.9%,p<0.05],with preoperative angiography in patients and review of the lesion degree of stenosis was statistically difference[12.9±4.9%vs.77.6 ± 8.9%,P<0.05],and the lesion degree of stenosis of patients with postoperative imaging review and postoperative had no significant differenence[12.9±4.9%vs.10.6±5.4%,P=0.173],the use of drug-coated balloon for in-stent restenosis lesions of immediate surgery success rate was 100%.Preoperative compared postoperative pathological changes with the minimum inner diameter,postoperative and preoperative patients with lesions of the minimum inner diameter was statistically difference[3.02±0.40mm vs.0.69±0.25mm,p<0.05],imaging with review of the patients and preoperative pathological changes of minimum diameter was statistically difference[2.95±0.40mm vs.0.69±0.25mm,P<0.05],the smallest diameter of patients atients with postoperative imaging review and postoperative had no significant difference[2.95 ± 0.40mm vs.3.02 ±0.40mm,P=0.173],the application of drug-coated balloons of surgery treatment of in-stent restenosis lesions immediate benefit was 2.33 ±0.34mm.Use of drug-coated balloon for in-stent restenosis lesions of 9-12 months after the late lumen loss was 0.07 ±0.18mm,consistent with the literature reported.Conclusion:1.Application of taxol drug coated balloon in the treatment of coronary artery in-stent restenosis lesions perioperative is safe and effective,and immediate surgery success rate of 100%,a satisfactory benefit from the surgery immediately,hospitalization,there was no cardiovascular adverse events.2.Clinical and imaging follow-up:application of taxol drug coated balloon in the treatment of coronary artery in-stent restenosis lesions 9-12 months after angina recurrence rate is low,the recurrence rate was 3.1%(1/32),and 9-12 months after review of segmental coronary angiography showed lesions did not see late lumen loss increased obviously?... |
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