摘要
目的观察62例无保护左主干病变并行介入治疗的患者,分析其临床特点,随访1年临床疗效。方法非随机入选符合标准的患者,术前常规给予阿司匹林和氯吡格雷(波立维)治疗,术中根据病变分布、血管直径选择单支架和T支架、V支架、对吻(kissing)支架、挤压(crush)支架和裤裙(clotte)支架双支架术,6个月和1年时电话或门诊随访死亡、心肌梗死、靶血管血运重建和外科搭桥等不良心血管事件。结果病变分布开口、体部和末端分叉所占比例分别是24.2%、20.1%和54.8%,其中56.5%(35例)的患者使用单支架,43.5%(27例)的患者使用双支架。1年随访,猝死1例,急性心肌梗死2例,靶血管重建2例,冠状动脉搭桥(CABG)3例,1年总不良心血管事件发生率12.9%。结论无保护左主干病变患者行药物洗脱支架治疗临床疗效可靠,不良事件发生率与CABG相当,对其有选择性地行介入治疗安全可行。
Objective To observe 62 unprotecting left main coronary artery cases who received percutaneous coronary artery intervention（PCI） in the hospital for one year,and to analyze clinical characters. Methods Selecting 62 standards-compliant cases nonrandomly, before PCI, the patients took aspirin and plavix regularly, adopting one stent or two stent technique including T, V,kissing stent,crush and clotte modus operandi, following up death, acute maycadiac infarction,target vessel revasculariztion and coronary artery bypass bridge（CABG） at 6th month and 1 year from operation. Results The ratio of lesions in ostial,body and distal bifurcation was 24.2% ,21.0% and 54.8% ,altogether 56.5% （35 cases） patients receiving single stent,43.5% （27 cases） receiving two stents. At one year follow-up, death 1 case, acute maycardiac infarction（AMI） 2 cases, target vessel revasculariztion（TVR） 2 cases, CABG 3 cases, total major adverse cardiac events（MACE） was 12.9%. Conclusion The clinical effect is good in unprotectin left main coronary artery cases who received PCI,total MACE is not higher than CABG, and selectively adopting PCI in unprotectin left main coronary artery cases is suitable.
出处
《临床荟萃》
CAS
2009年第21期1849-1851,共3页
Clinical Focus
关键词
冠状动脉疾病
支架
治疗结果
随访研究
coronary disease
stents
treatment outcome
follow-up study
