Stabil Koroner Arter Hastalığında Doğrudan Stentleme ve Ön-dilatasyon Sonrası Stentleme Yöntemlerinin TIMI Kare Sayısı Kullanılarak Karşılaştırılması

Abstract

Giriş: Stabil koroner arter hastalığında doğrudan stent ve perkütan translüminal koroner anjiyoplasti (PTKA) sonrasında stentleme yöntemlerinin koroner kan akımı üzerine etkisini karşılaştıran yeterli veri yoktur. Çalışmamızda, doğrudan stent ve PTKA sonrası stentleme yöntemlerinin koroner kan akımı üzerine etkisi TIMI kare sayısı (TKS) kullanılarak karşılaştırıldı.

Hastalar ve Yöntem: 2008-2012 yılları arasında perkütan koroner girişim (PKG) yapılan hastalar taranarak, doğrudan stentleme uygulanmış 55 hasta ve PTKA sonrası stentleme uygulanmış 42 hasta çalışmaya alındı. Hastaların PKG kayıtları izlendi. Her hasta için işlem öncesi ve sonrası TKS hesaplandı. İki tedavi grubu işlem öncesi ve sonrası TKS açısından karşılaştırıldı.

Bulgular: Doğrudan stent grubunda ortalama TKS işlem öncesinde 18.72 kare/saniye, işlem sonrasında 16.12 kare (fark 2.6 kare/saniye) bulundu; PTKA sonrası stent grubunda ise bu değerler sırasıyla 18.13 kare/saniye ve 16.63 kare/saniye (fark 1.5 kare/saniye) idi. İşlem sonrası TKS’deki azalma açısından iki grup arasındaki fark anlamlı idi (p< 0.001).

Sonuç: Bulgularımız, stabil koroner arter hastalığında doğrudan stentleme yönteminin koroner kan akımını iyileştirmede PTKA sonrası stentlemeye göre daha başarılı olduğunu gösterdi. Bu bulgu, doğrudan stentleme ile daha iyi mikrovasküler dolaşım sağlandığını düşündürmektedir.

Keywords

• Perkütan koroner girişim,anjiyoplasti,doğrudan stentleme

Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease

Abstract

Introduction: There are limited data comparing the effects of direct stenting and stenting after balloon percutaneous transluminal coronary angioplasty (PTCA) on coronary flow in patients with stable coronary artery disease (CAD). This study was designed to evaluate the effects of direct stenting and stenting after balloon PTCA on coronary flow using TIMI frame count (TFC) in patients with stable CAD.

Patients and Methods: After a retrospective review of patients who underwent percutaneous coronary intervention (PCI) from 2008 to 2012, we identified and included 55 patients who underwent direct stenting and 42 patients who received stenting after balloon PTCA. PCI records of the two study groups were reviewed to re-calculate pre- and post-PCI TFCs for comparison.

Results: The average pre- and post-procedural TFC values were 18.72 frames per second (fps) and 16.12 fps (difference 2.6 fps), respectively, in the direct stenting group. The corresponding TFC values were 18.13 fps and 16.63 fps (difference 1.5 fps) in the stenting after balloon PTCA group. The two groups differed significantly with respect to post-procedural decreases in TFC (p< 0.001).

Conclusion: Our findings show that, compared to stenting after balloon PTCA, direct stenting is more successful in terms of improved antegrade coronary blood flow in stable CAD patients, which suggests that direct stenting may contribute to better microvascular circulation.

Keywords

• Percutaneous coronary intervention,angioplasty,direct stenting

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