经皮冠状动脉介入治疗冠状动脉复杂病变的临床研究

Effect of percutaneous coronary intervention on coronary artery disease with complicated lesions.

目的探讨经皮冠状动脉介入治疗用于冠状动脉复杂病变（CAD—CL）的临床疗效。方法回顾性分析2002年8月至2008年9月我院对252例CAD-CL患者进行介入治疗的成功率、并发症及预后方面的临床资料。结果244例CAD—CL（包括慢性闭塞、分叉病变、长病变和再狭窄）患者成功置入支架（244／252，96．83％），无残余狭窄或残余狭窄〈20％。32例患者放置支架后出现侧支血管阻塞，48例出现动脉夹层，15例支架内形成再狭窄，未见其他严重并发症。1例急性前壁心肌梗死并发心源性休克患者，前降支置入2枚支架后仍处于低血压状态，经临时起搏器置入等积极抢救无效死亡，1例于术后第3天发生支架内亚急性血栓形成后经急诊PCI治疗闭塞血管再通，痊愈出院。结论经皮冠状动脉介入治疗对冠状动脉复杂病变是安全有效的。

Objective To assess the clinical efficiency of percutaneous coronary intervention （PCI） on coronary artery disease patients with complicated lesions （CAD-CL）. Methods A total of 252 patients of CAD-CL treated with PCI from August,2002 to September,2009 were enrolled in the study. Clinical data on prognosis e. g, success rate, complication occurrence and major adverse cardiac events were observed. Results Two hundred and forty-four patients with CAD-CL（ including chronic obstruction, bifurcation lesion, long lesion and restenosis） were implanted stent successfully（96.83% ）, with no residual stenosis or residual stenosis less than 20%. There were col- lateral obstructions in 32 patients and artery secret compartment in 48 patients, and restenosis in 15 patients. One patient of acute anterior myocardial infarction complicated by cardiogenic shock was in low blood pressure status after two anterior descending artery stent placement, and died after temporary pacemaker implantation and other positive rescue measures. One patient occurred subacute stent thrombosis on the third day, and was cured after occlusive vas- cular reeanalization through emergency PCI. Conclusions Pereutaneous coronary intervention for coronary artery disease patients with complicated lesion is safe and effective.