老年人无保护左主干病变经桡动脉途径介入治疗

Transradial percutaneous coronary interventional therapy for the elderly patients with unprotected left main coronary artery disease

目的探讨经桡动脉途径PCI在老年人无保护左主干病变(UPLMT)中的疗效和安全性。方法65岁以上的UPLMT患者28例择期行PCI,其中开口部6例,体部4例,分叉部18例,所有患者均置入药物洗脱支架。术后每半个月或1个月门诊复查1次,其中19例患者3～6个月行冠状动脉造影复查。结果28例患者PCI均取得成功,术后达TIMI3级血流,住院期间主要不良心脏事件1例,冠状动脉造影复查显示,支架内再狭窄1例(5.3%),再次行PCI。术后平均随访(18.6±2.7)个月,随访1年内无死亡。结论选择性经桡动脉老年UPLMT患者行PCI即刻成功率高,其近中期疗效可以被接受。

Objective To assess the clinical effectiveness and safety of transradial percutaneous coronary interventional （PCI） therapy using the drug eluting stent （DES） in the treatment of unprotected left main coronary artery disease （UPLMT）. Methods Between June 2005 and June 2007, a total of 28 consecutive patients with UPLMT were treated with elective PCI. All patients employed drug-eluting stents for the left main coronary artery, including 6 cases of ostial lesions, 4 midshaft and 18 bifurcation lesions. The patients enrolled in the study underwent clinical evaluation every half or one month after the procedure. Routine coronary angiography was performed 3 to 6 months after the procedure and angiographic follow-up was carried out in 680/oo of the patients （19/28）. Results Procedure success was achieved in 28 patients with UPLMT. The stenosis related arteries had TIMI 3 flow at the end of the procedure. The in-hospital major adverse cardiac event （MACE） rate was 3. 57%. Restenosis was observed in 1 patient, for whom repeated PCI was performed. There was no death during 12-month follow-up. Mean clinical follow-up period was 18.6±2.7 months. Conclusion Transradial percutaneous coronary interventional therapy for the treatment of UPLMT appears to be safe and feasible for selected aged patients and can bring about good immediate or medium-term outcomes.