DK-mini Culotte术式治疗冠状动脉分叉病变疗效的临床研究  

Curative effect of double-kissing mini culotte technique on coronary bifurcation lesion

作　　者：石宇杰[1] 张健[1] 李俊峡[1] 孙琪[1] 

机构地区：[1]北京军区总医院心血管疾病研究所,北京100700

出　　处：《中国循证心血管医学杂志》2015年第2期192-195,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：吴阶平医学基金(320.6700.1173)

摘　　要：目的观察双对吻非对称裙裤术式（DK-mini culotte）治疗冠状动脉真性分叉病变的疗效。方法入选2012年1月至2013年1月经冠脉造影证实真性分叉病变23例,给予DK-mini culotte术式置入双支架治疗。选取同期接受常规culotte术式双支架治疗患者25例作为对照组。随访12个月,并于术后9~12月复查冠脉造影,对两种术式即刻手术成功率、住院期间及30 d主要心脏不良事件（MACE）发生率以及复查冠脉造影冠状动脉再狭窄、随访12月主要心脏不良事件（MACE）进行比较。结果 DK-mini culotte术式最终球囊对吻扩张（FKB）成功率、手术成功率为100%,同culotte术式比较差异无统计学意义。两组手术时间、X线曝光时间以及对比剂用量比较,差异均无统计学意义（P〉0.05）复查冠脉造影,两组相比,边支再狭窄率分别为4.3%vs.16%,差异无统计学意义（P=0.397）;边支最小管腔直径[（2.44±0.39）mm vs.（2.19±0.47）mm],差异无统计学意义（P=0.052）：边支晚期管腔丢失[（0.35±0.23）mm vs.（0.51±0.32）mm],差异未达到统计学意义（P=0.054）。住院期间、术后30 d以及随访12个月,两组患者MACE事件发生率差异无统计学意义（P〉0.05）。结论 DK-mini culotte术式其FKB成功率及手术成功率均较高,同时伴有较低边支再狭窄率以及心脏不良事件发生率,治疗冠状动脉分叉病变具有较好的近期及远期疗效。Objective To observe the curative effect of double-kissing mini culotte （DK-mini culotte） technique on true coronary bifurcation lesion.Methods The patients with true coronary bifurcation lesion （n=23） were chosen from Jan. 2012 to Jan. 2013, and then given treatment of implanting 2 stents by DK-mini culotte technique （treatment group）. At the same period, 25 patients treated with implanting 2 stents by routine culotte technique （control group）. All patients were followed up for 12 m, and given coronary angiographic reexamination after procedure for 9 m to 12 m. The immediate success rate, in-hospital and 30-d incidence of major adverse cardiac events （MACE）, coronary restenosis and MACE in 12-m follow-up period were compared between 2 groups.Results The success rates of final kissing balloon （FKB） and operation were 100%, and the difference had no statistical significance between 2 groups. The difference in procedure time, X-ray exposure time and contrast dosage had no statistical significance between 2 groups （P〉0.05）. The results of coronary angiographic reexamination showed that the difference in restenosis rate of side branch （4.3%vs. 16%,P=0.397）, minimal lumen diameter of side branch （2.44±0.39 mmvs. 2.19±0.47 mm,P=0.052） and late lumen loss of side branch （0.35 ±0.23 mmvs. 0.51±0.32 mm,P=0.054） had no statistical significance between 2 groups. The difference in in-hospital, 30-d and 12-m follow-up incidence of MACE had no statistical significance between 2 groups （P〉0.05）. Conclusion The success rates of FKB and procedure of DK-mini culotte technique are higher and incidence of restenosis of side branch and MACE is lower. DK-mini culotte technique has good short-term and long-term curative effects on coronary bifurcation lesion.

关 键 词：冠状动脉疾病 经皮冠状动脉介入治疗 冠脉分叉病变 双对吻技术 改良裙裤术式 

分 类 号：R816.2[医药卫生—放射医学]