血管内超声指导左主干病变介入治疗的优势

Advantage of intravascular ultrasound guiding left main lesion intervention

目的:探讨血管内超声(IVUS)指导冠脉左主干病变介入治疗的优势。方法:入选100例左主干病变患者,患者被均分为IVUS组(50例,在IVUS指导下行支架植入)和对照组[50例,未行IVUS检查,经冠脉造影(CAG)评估后直接行支架植入术]。比较两组患者支架植入术后即刻情况及术后12个月随访结果的差异。结果:两组患者一般资料、左主干开口、体部和尾部病变比例,以及各类型斑块比例无显著差异(P均>0.05)。住院期间,IVUS组和对照组在急诊搭桥比例(0%比4%)和死亡率(0%比4%)方面无显著差异,但术后12个月,IVUS组支架内再狭窄发生率(4%比16%)和晚期贴壁不良发生率(6%比34%)显著低于对照组,P<0.05,<0.01。结论:应用血管内超声评价左主干病变指导介入治疗,有助于选择更合适的治疗方案,减少组织损伤和改善远期疗效。

Objective.. To explore advantage of intravascular ultrasound （IVUS） guiding coronary intervention. Meth- ods.. A total of 100 patients with left main （LM） lesion were selected and equally divided into 1VUS group （n = 50, received stent implantation under IVUS guidance） and control group [n = 50, received stent implantation after coro- nary angiography （CAG） evaluation without IVUS examination）. Instant condition after stent implantation and fol- low- up results after 12 months were compared between two groups. Results.. There were no significant difference in general data, percentages of LM opening, body part and tail lesions, different types of plaques between two groups, P〉0.05 all. During hospitalization, there were no significant difference in percentage of emergency coro- nary artery bypass grafting （0% vs. 4%） and mortality （0% vs. 4%） between IVUS group and control group （P〉0.05）. However, after 12 months, compared with control group, there were significant reductions in incidence rates of in-stent restenosis （16% vs. 4%） and late stent malapposition （34% vs. 6%） in IVUS group, P〈0.05, 〈0. 01. Conclusion： IVUS guiding left main lesion intervention is helps to select more appropriate therapeutic plan, reduce tissue injury and improve long- term therapeutic effect.