球囊支架对吻术治疗冠状动脉分叉病变的疗效观察

Application of balloon stent kissing technique in percutaneous coronary intervention for patients with coronary bifurcation lesions

关键词:  经皮冠状动脉介入治疗  分叉病变  球囊支架对吻术

Key words:  percutaneous coronary intervention  bifurcation lesions  balloon stent kissing technique

摘要:

目的 观察球囊支架对吻术治疗冠状动脉分叉病变的临床疗效。方法 连续入选2015年5月至2016年4月45例于同济大学附属东方医院心内科行球囊支架对吻术的冠状动脉分叉病变的患者,观察患者的临床特点、术中病变特点及术后影像学及短期临床事件情况的发生。结果 45例患者共有48处分叉病变处成功进行了球囊支架对吻治疗。其中大多数病变为(70.8%)为Medina1,1,1型。术后即刻TIMI3级血流,主支为100%,分支为96%。2例患者边支置入支架。术中边支内被拘禁的导丝及球囊均能顺利撤出。住院期间及出院1月内无明显的主要心脏不良事件发生。结论 在单支架方法(必要时分支置入支架)治疗分叉病变时,球囊支架对吻术是一种可行、有效的技术,能有效降低边支闭塞的风险,降低住院期间的主要心脏不良事件的发生率。

Abstract:

Objective To evaluate the clinical effectiveness of balloon stent kissing technique(BSKT) applied in percutaneous coronary intervention(PCI) for patients with coronary bifurcation lesions. Methods Forty five patients with bifurcation lesions underwent PCI using the BAKT from May 2015 to April 2016, The clinical conditions, characteristics of lesions, postprocedural quantitative coronary angiography(QCA) and immediate clinical outcomes were documented. Results BSKT was performed in 48 coronary bifurcation lesions from 45 patients. The majority of patients(70.8%) had medina class 1,1,1 bifurcation lesions. TIMI 3 flow was established in 100% of main branch and 96% of SB lesions. Two patients required provisional stenting of the SB. The jailed-balloon or wire was not entrapped during PCI. No main adverse cardiac events(MACE) occurred during hospitalization or 1 month after discharge. Conclusion Provisional stenting of coronary bifurcation lesions using a BSKT is associated with a high procedural success rate, and a low rate of SB occlusion and immediate cardiac events.