摘要
目的探讨冠状动脉支架术治疗择期无保护左冠状动脉主干(ULMCA)病变的安全性和术后平均2年的临床效果。方法回顾分析1997年9月至2007年1月在沈阳军区总医院接受冠状动脉支架植入术的416例 ULMCA 的病例资料。结果治疗对象中病变位于远端分叉处291例(70.0%)。ULMCA 靶病变共植入支架503枚,人均植入支架(1.2±0.7)枚。支架植入成功率99.5%,住院期间无死亡病例,靶病变重建2例,主要不良心脏事件(MACE)发生率0.5%(2/416)。随访期内共死亡16例(3.9%),其中心源性死亡12例(2.9%)。造影随访136例(33.1%),靶病变发生再狭窄20例(再狭窄率14.7%,20/136),其中14例行冠状动脉搭桥术,6例植入药物洗脱支架。ULMCA 病变择期行 PCI 后总的 MACE 发生率为8.3%(34/411)。结论冠状动脉支架术治疗择期无保护 ULMCA 病变的技术成功率、围术期安全性均较高,平均随访2年疗效较好。降低 PCI 术后再狭窄和 MACE 发生率的有效策略(如药物洗脱支架的选择和植入方法等)值得进一步探讨。
Objective To evaluate the safety and effectiveness of stenting for selective unprotected left main coronary artery （ULMCA） disease. Methods The clinical data of 416 patients with ULMCA who underwent selective percutanous coronary intervention （PCI） were analyzed. Results In 291 of the 416 patients （70.0%）, the ULMCA lesions were located in the distal bifurcation site. A total of 503 stents were successfully deployed in 414 patients and the mean stent number was （ 1.2 ± 0.7） stents per patient. The success rate of stenting procedure was 99.5%. During hospital stay, no patient died. The major adverse cardiac event （MACE） during in-hospitalization was 0.5% （2/416）. The target lesion revascularization （TLR） rate was 4.9%. During the follow-up 16 （3.9%） patients died including 12 cases （2.9%） of cardiac death. Angiography during follow-up conducted on 136 （33.1%） patients showed that binary instent restenosis occurred in 20 patients （14.7% ,20/136）. TLR was performed by coronary artery bypass graft in 14 patients and by drug eluting stent （DES） implantation in 6 patients respectively. The total MACE rate was 8.3% （34/411）. Conclusion Safe and with favorable clinical outcome, selective coronary stenting for ULMCA lesions can achieve a high technical success rate.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2007年第16期1109-1112,共4页
National Medical Journal of China
基金
全军首批临床高新技术重大项目基金资助([2002]卫医字第18号)
关键词
冠状动脉疾病
放射学
介入性
左冠状动脉主干
Coronary disease
Radiology, interventional
Left main coronary artery
