摘要
目的评价雷帕霉素洗脱支架在左主干末端分叉病变中应用的安全性及疗效。方法分析40例植入该支架的左主干末端病变的患者临床资料、手术术式、手术操作技巧、手术前后影像学结果、住院期间严重不良心性事件(MACEs)、出院后随访以及术后8个月的造影结果等。结果(1)患者平均最小管腔内径由术前(0.81±0.48)mm增加到了术后(3.53±0.22)mm。(2)手术即刻成功率为100.0%,住院期间的心绞痛复发率、病死率及急诊再次血运重建率均为0,非致死性心肌梗死病死率为2.5%。(3)平均随访(8.43±3.24)个月,MACEs发生率为20.0%。(4)27例(67.5%)患者术后8个月复查冠状动脉造影,22例(81.5%)患者左主干原支架内未见明显狭窄,5例(18.5%)患者左主干相关部位出现新病变,晚期管腔丢失平均为(2.18±0.11)mm。(5)不同手术方式的患者造影随访再狭窄率差异无统计学意义。结论雷帕霉素洗脱支架在经选择的左主干末端分叉病变中的应用,近期内是安全、有效的。
Objective To evaluate the acute and long - term results of stenting for left main coronary artery （LMCA） bifurcation lesions. Methods Forty consecutive patients with LMCA bifurcation lesion and normal left ventricular function were included. Sirollmus - eluting stents were performed in all patients. Results （ 1 ） The average diameter of LMCA was （ 0.81± 0.48 ） mm before stenting and increased to （3.53±0.22） mm after stenting. （2） The procedural success rate was 100.0%. In - hospital events including stent thrombosis, Q -wave myocardial infarction, and emergency bypass surgery did not occur in any patients, and non - Q - wave MI in one patient （ 2.5% ）. （ 3 ） Clinical follow - up was obtained in all patients at （ 8.43 ＋ 3.24 ） months. There were no death and no myocardial infarction during followup. The major adverse cardis events rate was 20.0%. （4）The angiographic follow- up rate was 67.5 % （27 of the 40 eligible patients ）, and the restenosis rate was 18.5 % （ parent vessel only 11.1%, side branch only 3.7% , and both 3.7% ）. （5）Different type of operation had no influence on restenosis rate during angiographic followup. Conclusion Sirolimns -eluting stent implantation for LMCA bifurcation stenosis appears safe and effective with regard to acute and midterm complications.
出处
《中国医师进修杂志（内科版）》
2006年第7期14-16,共3页
Chinese Journal of Postgraduates of Medicine
关键词
左主干
分叉病变
药物洗脱支架
Left main
Bifurcation lesion
Sirolimus - eluting stent
