Review of interventional therapy for coronary heart disease

summary

Interventional therapy of coronary heart disease has become a very common treatment method, which has the characteristics of small damage, safety, fast recovery and so on. It is the first choice for many patients with coronary heart disease. The following experts will introduce several methods of interventional treatment for you, and hope you can make a reasonable choice according to your own condition.

Review of interventional therapy for coronary heart disease

First: percutaneous transluminal coronary angioplasty (PTCA): the catheter, guide wire and balloon are sent to the corresponding stenosis site of coronary artery by puncture of femoral artery or radial artery, and then dilated for several seconds to several minutes to eliminate coronary artery stenosis. With the accumulation of experience and the improvement of balloon performance, the success rate of PTCA is increasing. Even so, the mechanism of common balloon dilation is due to the irregular tearing of vascular intima and media caused by high-pressure balloon dilation, so PTCA still has its own limitations: balloon dilation can not always make the vascular lesions fully expanded, the inner diameter of the vessel fully increased, the elastic retraction of the vessel, the tearing, dissection and acute occlusion of the vascular wall at the dilation site. Therefore, the restenosis rate after PTCA alone is still 30% - 35%.

Second: cutting balloon technology (CBA): cutting balloon is inlaid with 3-4 pieces of equal angle on the longitudinal axis of the surface of common balloon, with a height of about 10 mm The mechanism of dilation of 0.2-0.3 mm blade is that the attached blade cuts through the intima and media of the lesion by using the pressure of the balloon, and then the proliferative intima tissue in the stent is pushed out of the framework structure of the stent due to the extrusion effect of balloon expansion; Therefore, the damage of CBA to the vascular wall is small, and the inflammatory reaction of the vascular wall is light, which can reduce the incidence of restenosis to about 15%.

Third: coronary stenting (stent): coronary stent is a kind of tubular material which can be expanded by balloon, porous stainless steel (or other metal such as cobalt alloy) and plays a supporting role. It adheres to the surface of balloon and is sent to the vascular lesion by delivery system for release. It completely solved the restenosis caused by elastic retraction and negative remodeling after PTCA, and significantly reduced the restenosis rate, about 13% - 18%. With the development of coronary intervention, antiplatelet drugs (clopidogrel, platelet glycoprotein IIb / IIIa receptor antagonist) and anticoagulant drugs (heparin), the incidence of thrombosis decreased significantly, less than 0.5%; The emergence of drug-eluting stents (rapamycin, paclitaxel, etc.) makes the restenosis rate reduce to less than 10% again, which gives people great encouragement. However, it still needs the evidence-based results after long-term, large sample and multi lesion type observation. Even in stent restenosis, CBA and brachytherapy can be used again.

matters needing attention

The above introduces several interventional treatment methods for coronary heart disease, and experts remind patients to make a good diagnosis before treatment, so as to avoid misdiagnosis and aggravation of the disease. At the same time, we should also do a good job in the prevention and nursing of this disease in our daily life to avoid the occurrence of the disease.