冠状动脉介入诊疗中左主干夹层的原因分析及处理

Analysis of reasons and treatment of left main coronary artery dissection in percutaneous coronary intervention

目的:探讨冠状动脉诊疗中左主干夹层的原因、预防措施及处理方法。方法:回顾性分析6例急性左冠状动脉主干夹层患者的临床资料、手术过程、器械选择及预后。结果:6例左主干夹层患者5例及时植入支架后即刻均获得良好效果,1例亚急性血栓形成导致死亡;4例中远期预后良好,无严重不良心血管事件发生。结论:急性左主干夹层预后凶险,支架置入术可获得良好治疗效果。

Objective To analyze the reasons, prevention and treatment of dissection of left main coronary artery in percutaneous coronary intervention. Methods Six cases complicated with left main coronary artery dissection were retrospectively analyzed including the clinical data, procedure, apparatus selection and prognosis. Results Five cases in the 6 cases were successfully implanted stents and received an immediate good result, in which 1 died of subacute in-stent thrombosis and 4 cases had good medium- and long-term outcome without severe main adverse cardiovascular events. Conclusion The dissection of left main coronary artery in percutaneous coronary intervention is very dangerous. Stent implantation can achieve a good result.