摘要
目的:评估不同经皮冠状动脉介入(PCI)策略对孤立性前降支开口病变的治疗效果。方法:回顾性分析2021年3月—2023年10月于阜外华中心血管病医院接受PCI治疗的112例冠状动脉(冠脉)开口病变患者,按介入策略分为3组:球囊支架组(52例)、精确定位组(22例)和跨越支架组(38例)。血管内超声(IVUS)用于术前、术后对开口及斑块特性的评估。术后随访12个月,评估术后主要不良心血管事件(MACE)发生率。结果:IVUS分析显示,3组患者术前开口面积、术后开口面积、即刻管腔获得、斑块性质均差异无统计学意义。随访12个月后,3组MACE发生率存在显著差异(1.9%vs.18.2%vs.7.9%,P=0.039)。结论:球囊支架混合策略在孤立性前降支开口病变的治疗中显示出较好预后,MACE发生率较低。
Objective To evaluate the therapeutic effects of different percutaneous coronary intervention (PCI) strategies in isolated left anterior descending (LAD) ostial lesions.Methods A retrospective analysis was conducted on 112 patients with LAD ostial lesions who underwent PCI at Fuwai Central China Cardiovascular Hospital between March 2021 and October 2023. Patients were divided into three groups according to the intervention strategy: balloon with stenting group (n=52), precise ostial stenting group (n=22), and crossover stenting group (n=38). Intravascular ultrasound (IVUS) was used for pre-and post-procedural assessment of ostial and plaque property. The incidence of major adverse cardiovascular events (MACE) was assessed during the 12-month post-procedural follow-up.Results IVUS analysis showed that pre-procedural ostial area, post-procedural stent area, immediate lumen acquisition, and plaque property were not significantly different among the three groups. At the 12-month follow-up, there was a significant difference in the incidence of MACE among the three groups (1.9% vs. 18.2% vs. 7.9%, P=0.039).Conclusion The combination of drug-coated balloon and stent implantation has shown better outcomes in treating isolated LAD ostial lesions, with a lower incidence of MACE.
作者
晁好一
晏娟娟
高瑾
张家惠
李凌月
杨英
高传玉
王宪沛
CHAO Haoyi;YAN Juanjuan;GAO Jin;ZHANG Jiahui;LI Lingyue;YANG Ying;GAO Chuanyu;WANG Xianpei(Department of Cardiology,Central China Fuwai Hospital,Zhengzhou University,Zhengzhou,450000,China;Department of Cardiology,Heart Center,Fuwai Central China Cardiovascular Hospital,Henan Provincial People's Hospital;Department of Cardiology,People's Hospital of Henan University)
出处
《临床心血管病杂志》
2025年第7期535-541,共7页
Journal of Clinical Cardiology
关键词
冠心病
前降支开口病变
血管内超声
药物洗脱支架
药物涂层球囊
coronary artery disease
left anterior descending ostial lesions
intravascular ultrasound
drug-eluting stent
drug-coated balloon
