简单支架术与复杂支架术对左主干分叉病变疗效比较  

Effects of Simple or Complex Stenting Techniques on Left Main Bifurcation Lesions

作　　者：李珊[1] 盖鲁粤[1] 杨庭树[1] 王禹[1] 刘宏斌[1] 陈练[1] 

机构地区：[1]解放军总医院,北京市100853

出　　处：《中国康复理论与实践》2007年第9期882-883,共2页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的评价无保护左主干分叉病变不同支架治疗策略的的近远期疗效。方法分析27例无保护左主干分叉病变接受介入治疗患者的临床结局,其中采用简单支架技术横跨技术（crossover）14例,复杂支架技术包括挤压技术（crush）、T支架术（T-stenting）、V支架术（V-stenting）等13例。结果共植入40枚支架,操作成功率100%,住院期间无主要心脏不良事件（MACE）。真性分叉病变复杂支架术组较简单支架术组多（84.6%vs14.3%,P=0.0004）,复杂支架术组合并更多多支病变（100%vs57.1%,P=0.0074）。支架植入术后即刻前降支开口残余狭窄复杂支架术组（10.85±5.51）%较简单支架术组（4.29±4.25）%明显增高（P=0.002）,回旋支（left circumflex artery,LCX）开口残余狭窄复杂支架术组（4.61±3.01）%较简单支架术组（13.63±11.21）%明显减轻（P=0.009）。出院随访2~53个月,心绞痛复发3例（11.1%）,靶病变血运重建（TLR）2例（7.41%）,MACE2例（7.41%）。二组心绞痛复发率（7.1%vs15.4%,P=0.59）和TLR发病率（0%vs15.4%,P=0.13）均无显著性差异。结论各种支架植入技术均能取得较好的近远期疗效。Objective To evaluate the immediate and long-term outcomes of left main bifurcation lesions using different stenting techniques.Methods 27 patients undergone unprotected left main coronary artery stenting had been analyzed.14 cases with simple stenting techniques and 13 cases with complex stenting techniques were involved.Results 40 coronary stents were deployed in 27 patients.The procedural success rate was 100%.No major adverse cardiac events（MACE）had developed in hospital.More true bifurcation lesions were involved in complex stenting group than in simple stenting group（84.6% vs 14.3%,P=0.0004）,as well as multivessel lesions involved（100% vs 57.1%,P=0.0074）.The residual ostial restenosis of left anterior descending artery（LAD）in complex stenting techniques group was more than that in simple stenting techniques group（（4.29±4.25）vs（10.85±5.51）,P=0.002）.The residual ostial restenosis of left circumflex artery（LCX）in complex stenting group was less than that in simple stenting group（（4.61±3.01）vs（13.63±11.21）,P=0.009）.The patients were followed up for 2～53 months.Angina pectoris recurred in 3 cases（11.1%）and target lesion revascularization（TLR）developed in 2 cases（7.41%）.The total MACE happened in 2 cases（7.41%）.There was no significant difference between complex stenting group and simple stenting group about symptom recurrence（7.1% vs 15.4%,P=0.59）and TLR（0 vs 15.4%,P=0.13）.Conclusion Both simple and complex stenting techniques are feasible with better in-hospital and long-term outcomes.

关 键 词：冠状动脉性心脏病 左主干分叉病变 支架术 

分 类 号：R541.4[医药卫生—心血管疾病]