BSKT技术与Reverse crush支架术治疗冠状动脉分叉病变的疗效比较

Comparison between balloon-stent kissing technique and reverse crush stenting in treating coronary bifurcation lesions

目的：探讨对比BSKT技术与reverse crush支架术治疗冠状动脉分叉病变的临床疗效。方法选取2012年9月～2014年9月本院接诊的120例冠状动脉分叉病变的患者作为研究对象，随机抽取60例患者采取BSKT技术进行治疗，该组研究对象作为观察组；另60例患者采取reverse crush支架术进行治疗，作为对照组。观察两组患者手术时的时间、造影剂用量、球囊用量等；术后的主支血管的直径以及再狭窄情况等；对所有患者进行跟踪随访，记录患者心脏发生的心绞痛、心肌梗死等心脏不良事件的发生情况。结果观察组进行手术的时间、X线曝光时间、造影剂的用量以及球囊用量都低于于对照组，具有统计学意义（P＜0.05）；两组患者术后的主支血管直径均大于或等于2.5mm，分支血管直径大于等于2.0mm，观察组球囊吻合度高于对照组，但两组无显著差异（P＞0.05）。对患者随访发现观察组发生心脏不良时间的发生率低于对照组，但无统计学差异（P＞0.05）。结论 BSKT技术与reverse crush支架术比较，具有手术治疗上的优势，对于患者术后的康复也有较好的趋势，值得大力推广。

Objective To evaluate and compare the clinical efficacy of balloon-stent kissing technique （BSKT） versus reverse crush stenting in treating coronary bifurcation lesions. Methods A total of 120 patients with coronary bifurcation lesions who were admitted to our hospital from September 2012 to September 2014 were enrolled in the study. Sixty patients were randomly assigned to the observation group and treated with BSKT, and the other 60 patients were assigned to the control group and treated with reverse crush stent implantation. The operation time, dose of contrast agent, number of balloons, postoperative diameters of the main and side branch vessels, and the incidence of restenosis were compared between the two groups. All patients were followed up, and the incidence of adverse cardiovascular events including angina pectoris and myocardial infarction was recorded. Results The observation group had significantly shorter operation time and X-ray exposure time, a significantly lower dose of contrast agent, and a significantly less number of balloons than the control group （all P〈0.05）. The postoperative diameters of the main branches were greater than or equal to 2.5 mm, and those of the side branches were greater than or equal to 2.0 mm in both groups. The balloons in the observation group fit slightly better than those in the control group, but the difference was not significant （P〉0.05）. The incidence of adverse cardiovascular events during the follow-up period in the observation group was slightly lower than that in the control group, but no significant difference was observed （P〉0.05）. Conclusion BSKT has advantages in surgical treatment and postoperative rehabilitation of patients compared with reverse crush stenting. The clinical application of BSKT is highly recommended.