无保护左主干病变的介入治疗  

Percutaneous coronary interventional therapy for unprotected left main coronary artery disease

作　　者：陈曦[1] 土井修[1] 望月守[1] 屈百鸣[1] 吴立萱[1] 

机构地区：[1]浙江省人民医院,浙江杭州310014

出　　处：《现代中西医结合杂志》2006年第20期2750-2751,2754,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨经皮冠状动脉介入治疗(PCI)在无保护左主干病变(UPLMT)中的疗效和安全性。方法共选择36例UPLMT行PCI,其中开口部9例,体部17例,分叉部7例,从开口到分叉全部累及3例,单独血栓吸引疗法1例,其余35例为球囊扩张后支架置入或原发性支架置入,7例为急诊PCI。术后每半个月门诊复查1次,3个月和6个月分别行冠状动脉造影(CAG)含或不含血管内超声复查。结果36例患者介入治疗均取得成功,术后达TIMI 3级血流,住院期间主要不良心脏事件(MACE)3例(8%),0.5 a CAG复查显示再狭窄共8例(22%),其中2例发生在3个月内。再狭窄病变中的7例予靶血管血运重建(TVR),包括5例(14%)PCI,2例外科手术(6%),术后随访0.5 a未发现死亡,心功能明显改善。结论对UPLMT行PCI是安全的,其近中期疗效可以被接受,并使患者的心功能得到改善。Objective h is to explore the efficacy and safety of percutaneous coronary intervention （PCI） on unprotected left main coronary artery disease （UPLMT）. Methods 36 patients with UPLMT undergoing PCI were chosen, among whom 9 cases are for ostial lesion, 17 for mid shaft lesion, 7 for bifurcation lesion, and 3 for both ostial and bifurcation lesion, 1 treated with single thrombus aspiration, and the rest 35 cases were given primarily deployed stems or given pereutaneous transluminal coronary angioplasty （PTCA） before deployment of coronary stents, 7 cases were performed on with emergency PCI. Clinical follow-up examinations were done on the patients in out-patient clinic every two weeks, and coronary artery angiography （CAG） in 3 and 6 months, with or without intravascular ultrasound examination. Results Procedure success was achieved for all the 36 cases. The stenosis related arteries had TIMI 3 flow at the end of the procedures. 3 cases （8%） got major adverse cardiac events （MACE） during hospitalization, and 8 cases （22 % ） appeared restenosis by CAG examination in 6 months, among whom 2 cases were within 3 month. 7 restenosis cases were given target vascular revascularization （TVR）, including 5 cases by PCI, and 2 cases by surgery operation. There was no death case after PCI within 6 month and cardiac function was improved obviously. Conclusion It is safe to use PCI on UPLMT, which can improve the cardiac function of patients, and it is acceptable for the immediate and medium term efficacy.

关 键 词：无保护左主干病变 经皮冠状动脉介入治疗 再狭窄 

分 类 号：R543.3[医药卫生—心血管疾病]