On May 21, 2025, Chief Physician Peng Xiaoping, Director of the Department of Cardiology at the First Affiliated Hospital of Nanchang University, led his team including Chief Physician Zhu Jianbing, Deputy Chief Physician Tong Yifan, and Deputy Chief Physician Hua Jinghai to complete the first case of coronary artery remodeling catheter combined with laser generator treatment for primary coronary small vessel disease in Jiangxi Province.
Patient Data
Male, 50 years old, complained of chest tightness and shortness of breath for 8 days. He was admitted to the hospital for "coronary atherosclerotic heart disease".Admission examination: Preoperative electrocardiogram showed partial ST-T changes in leads and incomplete right bundle branch block. Preoperative cardiac ultrasound prompt, LVEF：65%； The left room is large. Hematological examination suggests that creatine kinase is 84.1U/L; Troponin T 5.61pg/ml; Creatinine is 51.8umol/L.Admission diagnosis: coronary atherosclerotic heart disease.
The patient is in a supine position, with routine disinfection and local anesthesia with 1% lidocaine. The right radial artery is punctured, a 6F vascular sheath is implanted, fully heparinized, and a multifunctional contrast tube is sent to the opening of the left and right coronary arteries. The contrast agent is propafenone, manually pushed at 4-6ml/time, and taken at 15 frames/s. Intraoperative imaging shows no obvious abnormalities in the left main trunk, plaque formation in the middle of the anterior descending branch, 30-40% stenosis of the lumen, and TIMI3 grade distal blood flow; No obvious abnormalities were found in the circumflex branch, the distal blood flow was TIMI3 grade, the right crown was displaced, the wall of the proximal and middle segments was not smooth, and no obvious stenosis was observed in the lumen. Limited 95% stenosis was observed in the middle segment of the posterior descending branch, and the distal blood flow was TIMI3 grade. Explain the condition to the family members, obtain their consent, and after joint discussion with Chief Physician Peng Xiaoping, Chief Physician Zhu Jianbing, Deputy Chief Physician Tong Yifan, and Deputy Chief Physician Hua Jinghai, decide to intervene and lower the coronary artery. Send SAL1.0 guide catheter along the right radial artery sheath to the opening of the right coronary artery, and then send SION and minimally invasive guide catheters to the distal end of the posterior descending artery. Send a 2.0 * 20m pre expansion balloon and a 2.5 * 15mm scoring balloon along the SION guide catheter to the lesion site in the middle of the posterior descending artery at 10atm for dilation. Follow up with residual stenosis<20% on angiography, exit the minimally invasive guide catheter, and send it to the Zhengzheng Medical Coronary Artery Re plastic Catheter (specification: 2.75mm * 20mm) to the lesion site in the middle of the posterior descending artery. Expansion at 8atm for 60 seconds, no residual stenosis was found on follow-up angiography, and the distal blood flow of the posterior descending branch was TIMI3 grade.
Background Introduction
Coronary atherosclerotic heart disease (CAD) is a kind of heart disease that causes myocardial ischemia, hypoxia or necrosis due to the stenosis or occlusion of lumen caused by lipid deposition under the intima of coronary artery, formation of fibrous plaque or secondary thrombosis. Typical manifestations include angina pectoris, myocardial infarction, or heart failure, and treatment mainly involves medication, intervention, or surgical intervention.
Small vessel disease "refers to a narrow lesion in the distal branch of the coronary artery, with a reference vessel diameter typically ≤ 2.75-3.0 mm. Due to the small lumen and poor elasticity, this type of disease is difficult to intervene in, and is prone to poor stent adhesion, restenosis, or thrombosis. Immediate acquisition of the lumen after surgery has a significant impact on the treatment outcome.
In terms of the selection of interventional treatment methods, drug-eluting stents (DES) can release anti proliferative drugs and provide radial support to prevent narrowing of the lumen caused by elastic retraction of blood vessels, but they have permanent implants and require long-term antiplatelet therapy. The drug coated balloon (DCB) is withdrawn immediately after the drug is released from the wall, which requires less platelet therapy but cannot provide sustained support, and is prone to vascular dissection and elastic retraction.Ju Zheng Medical's Coronary Vessel Remodeling Catheter (NVS) is the first to introduce photocrosslinking technology into the field of coronary therapy. By inducing photocrosslinking reactions in the extracellular matrix of blood vessels, an in-situ micro crosslinked structure is constructed, effectively reducing the occurrence of dissection and wall rebound. After withdrawal, no foreign objects are left, maintaining the natural anatomy and physiological characteristics of the vascular lumen without the need for long-term antiplatelet therapy, and truly achieving "intervention without implantation".
