冠状动脉介入术中支架影像增强显影技术与血管内超声对照研究

摘要

探讨支架增强显影技术(stentboost,SB)在评价支架植入效果和指导支架内球囊后扩张与血管内超声(intravascular ultrasound,IVUS)的相关性。方法26例患者在支架植入、支架内球囊后扩张时,完成了冠状动脉造影定量分析(quantative coronary angiography,QCA)、SB技术、IVUS检查,植入支架35枚。分别通过 QCA、SB、IVUS获取支架植入、支架内球囊后扩张完成时支架直径,计算支架偏心指数；各项检查所测支架植入、支架内球囊后扩张完成时支架直径和支架偏心指数的自身对照,检查之间所测数据进行相关性分析。结果 QCA、SB、IVUS测量的支架内球囊后扩张完成时支架直径均较支架植入时明显增加,支架偏心指数[(最大支架直径-最小支架直径)/最大血管直径]降低。SB与IVUS测量的支架植入时、支架内球囊后扩张完成时的支架平均直径具有最好的相关性(r=0.982,P<0.01；r=0.985,P<0.01)；而且 QCA与IVUS也具有较好的相关性(r=0.975,P<0.01；r=0.978, P<0.01)；QCA与 SB也明显相关(r=0.972,P<0.01；r=0.976,P <0.01)。结论支架内球囊后扩张完成时支架偏心指数较支架植入时更低,与 QCA相比,SB与 IVUS测量的支架植入时、支架内球囊后扩张完成时的支架平均直径有更好的相关性。%To discuss the correlation between StentBoost(SB)and intravascular ultrasound(IVUS) for assessing stent implantation and guiding the stent post dilatation.Methods Twenty-six patients were analyzed using quantitative coronary angiography(QCA),IVUS,and SB,35 stents were implanted.Twenty-six patients (35 stents)were performed with postdilatation.Stent diameter poststenting and postdilation were measured by QCA,by IVUS by SB respectively;the ratio (maximum stent diameter [MaxLD]-minimum stent diameter [MaxLD]/MaxLD were calculated respectively.Stent diameter were analyzed in poststenting and postdilation check;correlations of three chicks were analyzed.Results The minimum diameter,maximum diameter and average diameter of postdilatation obtained by QCA,IVUS,SB were significantly larger than those of poststenting,and the ratio (maximum stent diameter [MaxLD]-minimum stent diameter [MaxLD]/MaxLD of postdilatation was smaller.Correlations of average diameter were the best between IVUS and SB (r=0.982,P<0.01;r=0.985,P<0.01),and those were also better between QCA and SB (r =0.975,P <0.01;r =0.978,P <0.01),futher more those by QCA and IVUS were significant(r=0.972,P <0.01;r=0.976,P <0.01)in stent implantation and post-dilatation.Conclusion The stent eccentricity index becomes small after postdilatation in every group;SB has superior correlations for stent directers measured by IVUS when compared with QCA of stent implantation and postdilatation.