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直接血管成形术中远端栓塞:组织病理学特征和预测参数

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 24-24页

作者： limbruno u. De Carlo M. Pistolesi S. R. De Caterina 高登峰 Dr. Department of Cardiology G. d'Annunzio University-Chieti C/o Ospedale S. Camillo de Lellis Via Forlanini 50 66100 Chieti Italy

Background: Distal embolization during primary percutaneous coronary interventions(PCIs) may affect myocardial reperfusion. We evaluated the prevalence and features of embolization during primary PCI and its relationship with clinical and angiographic variables. Methods: Forty-six consecutive patients with acute myocardial infarction underwent primary PCI with a filter-based distal protection device. Histopathologic analysis was performed on retrieved embolic fragments, assessing the presence and relative amount of fibrin, necrosis, lipid droplets, collagen, mucopolysaccharides, and leukocytes, as well as the total debris volume. Such variables were related to baseline clinical and angiographic variables. Results: Embolic material was recovered in 41(89%) of 46 cases, with a mean total debris volume of 1.2±2.2 mm3. Prevalent histopathologic patterns were organized thrombus(47%), fresh thrombus(29%), and plaque fragments(24%). At multivariate analysis, none of the baseline clinical variables considered significantly predicted the total debris volume. Among angiographic variables, angiographic signs of high thrombus burden(cut-off coronary occlusion pattern or large intracoronary minus image) independently predicted the total debris volume at multivariate analysis(odds ratio 15.8, Puse, abciximab did not affect the total number and the mean total volume of embolized material(15±16 vs 10±8 fragments, 1.5±2.5 vs 1.0±1.9 mm3, respectively, for both P >.20), or its qualitative composition. Conclusions: Distal embolization occurs in most patients during primary PCI and mainly consists of plaque fragments and partially organized thrombi, which are likely to be scarcely responsive to antiplatelet drugs. Baseline angiographic signs of a high thrombus burden are the only significant predictors of the extent of distal embolization.

关键词：组织病理学特征远端保护装置预测参数直接血管成形栓塞经皮冠状动脉介入术直接PCI 术中心肌梗死患者临床参数

欧洲和中国的心脏与肾脏远程缺血预适应研究:一项随机对照试验

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中华高血压杂志 2018年第4期26卷 334-334页

作者：刘青叶鹏 Moretti C Cerrato E Cavallero E Lin S Rossi ML Picchi A Sanguineti F ugo F Palazzuoli A Bertaina M Presbitero P Shao-Liang C Pozzi R Giammaria M limbruno u Lefèvre T Gasparetto V Garbo R OmedèP Sheiban I Escaned J Biondi-Zoccai G Gaita F Perl L D'Ascenzo F

远程缺血预适应（remote ischemic preconditioning,RIPC）对经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）术后造影剂肾病（contrast-induced nephropathy,CIN）的潜在保护作用尚待确定。该研究为双盲、随机、安慰剂对照的多中心研究,纳入年龄〈85岁,肾清除率为30～60mL/（min·1.73m^2）的有临床适应证的患者,除了直接PCI外均按1∶1给予RIPC或标准治疗。主要终点是CIN的发生率。次要终点是围手术期心肌梗死（peri-procedural myocardial infarction,PMI）的发生率。

关键词：随机对照试验缺血预适应远程经皮冠状动脉介入治疗肾脏心脏中国欧洲

经尺动脉途径介入治疗冠心病术后半年平板运动试验评估心功能

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中国临床康复 2003年第24期7卷 3346-3347页

作者：孙玲郭群萍李艳华王玲孙晓东张迪 limbruno ugo 抚顺市中心医院循环内科辽宁省抚顺市113006 意大利比萨大学心胸部 56124

目的:观察经尺动脉途径介入治疗冠心病术后半年平板运动试验对心功能的评估结果,比较经尺动脉途径和经桡动脉途径介入治疗的可行性。方法:在10例患者中应用经尺动脉途径成功7例,其中5例为冠脉造影,2例为支架植入,与经桡动脉途径病例105... 详细信息

目的:观察经尺动脉途径介入治疗冠心病术后半年平板运动试验对心功能的评估结果,比较经尺动脉途径和经桡动脉途径介入治疗的可行性。方法:在10例患者中应用经尺动脉途径成功7例,其中5例为冠脉造影,2例为支架植入,与经桡动脉途径病例105例进行比较,并对两组患者中接受经皮腔内冠状动脉成形术(percutaneoustransluminalcoronaryangioplasty,PTCA)及支架植入者进行随访,同时应用活动平板运动试验评估患者心功能情况。结果:经桡动脉途径与经尺动脉途径穿刺及导管操作的平均时间犤冠状动脉造影(60±30)min,PCI(83±24)min犦差异无显著性意义。冠状动脉造影及支架植入的成功率经两种途径差异无显著性意义。7例患者中没有并发症发生,术后随访平板运动试验评价的心功能均得到改善。结论:尺动脉可作为另一个可行的冠状动脉诊断和治疗途径,同时可保留桡动脉用于做外科冠脉搭桥。经尺动脉途径介入治疗冠心病后通过活动平板运动试验检测发现,此种术式能显著改善患者术后的心功能。

关键词：经尺动脉途径介入治疗冠心病术后平板运动试验评估心功能