ABSTRACT
Objective To compare the clinical effect of three methods of treatment for the in-stent restenosis(ISR)after percutaneous coronary intervention(PCI),drug coated balloon(DCB)compared with common balloon and drug eluting stent(DES).Methods From August 2014 to January 2018,95 cases of ISR in the Second Affiliated Hospital of Southeast University were diagnosed by coronary angiography.They were treated with common balloon,DCB or second generation DES.The patients were assigned to the DCB group 25 cases or the second-generation DES group(23 cases)and balloon group(47 cases)according to the therapeutic strategies they accepted.Major adverse cardiac events(MACE)of patients were followed by telephone or hospital visit at 6-12 months.MACE was defined as a composite of cardiac death,nonfatal myocardial infarction(MI),and target vessel revascularization(TVR).Results In summary,95 patients with DES-ISR were enrolled,including 47 patients in the balloon group,23 patients in the DCB group and 25 patients in the second-generation DES group.Coronary angiography was performed 6-12 months after operation.The minimum lumen diameter(MLD)of the DCB group was significantly larger than those of the balloon and DES groups[(1.86 ±0.27)mm vs.(2.16 ±0.43)mm,t =3.57,P =0.00;(1.94 ±0.31)mm vs.(2.16 ± 0.43)mm,t=2.05,P=0.05].The restenosis rate of the DCB group was significantly lower than those of the balloon group and DES group[15 cases(31.91％)vs.2 cases(8.69％),χ2 =4.53,P=0.02;8 cases(32.00％)vs.2 cases(8.69％),χ2 =2.66,P=0.05].The rate of late lumen loss(LLL)in the DCB group was significantly lower than those of balloon group and DES group [(0.67 ±0.28)mm vs.(0.21 ±0.18)mm,t =7.17,P =0.00;(0.43 ± 0.28)mm vs.(0.21 ±0.18)mm,t=3.21,P=0.00].MACE was significantly lower than balloon group and DES group[16 cases(34.04％)vs.1 cases(4.76％),χ2 =7.02,P=0.01;8 cases(32.00％)vs.1 cases(4.76％),χ2 =4.06,P=0.02].Conclusion Drug balloon dilatation in stent restenosis is more effective and safer than common balloon dilatation and re-implantation of drug eluting stents.
ABSTRACT
Objective To observe the efficacy and safety of 150 mg clopidogrel and triple antiplatelet in acute anterior myocardial infarction ( AMI) patients undergoing percutaneous coronary intervention ( PCI).Methods Totally 50 patients who had been diagnosed as acute anterior myocardial infarction and prepared to PCI treatment were randomly divided into two groups:150 mg clopidogrel group ( asprin 100 mg/d qd+clopidogrel 150 mg/d qd) and triple antiplatelet group ( cilostazol 100 mg bid+asprin 100 mg/d qd+clopidogrel 75 mg/d qd).The coronary lession through CAG, incidence of major cardiovascular events and safety in 6 months were observed and assessed.ResuIts There was no significant difference in level of target lesion diameter between two groups after PCI instantly (2.75 ±0.29 mm vs.2.69 ±0.31 mm).There were no significant differences of late lumen loss (LLL) and target lesion revascularization (TLR) between triple antiplatelet group and 150 mg clopidogrel group (0.22 ±0.46 mm vs.0.38 ±0.65 mm; 8%vs.24%) , but the two indexes were improved in a certain extent.There were no significant differences in hemorrhage and major adverse cardiovascular events ( MACE) between two groups.ConcIusion The triple antiplatelet therapy could reduce the late lumen loss and target lesion revascularization, and not increase hemorrhage and adverse cardiovascular events.