DK mini-culotte支架术式治疗冠状动脉分叉病变疗效分析

Curative effect analysis of DK mini-culotte stenting for coronary bifurcation lesions

目的探讨双对吻微型裙裤(DK mini-culotte)支架术式治疗冠状动脉分叉病变的临床疗效。方法选取在广东省农垦中心医院和广东医科大学附属医院经冠状动脉造影确诊的冠状动脉分叉病变患者68例,随机分为实验组和对照组,每组34例。实验组分叉病变患者采用DK mini-culotte术式,对照组分叉病变患者均按照常规culotte术式完成双支架术,观察两组患者的手术成功率、最终球囊对吻扩张的完成情况、手术时间、造影剂用量以及随访6个月时严重心脏不良事件的发生率。结果两组手术时间、手术成功率、造影剂用量、最终球囊对吻扩张的完成率差异均有统计学意义(P<0.05),其中实验组的手术时间、造影剂用量显著低于对照组,手术成功率、最终球囊对吻扩张的完成率显著高于对照组。两组随访6个月时严重心脏不良事件发生率分别为5.88%和23.53%,差异具有统计学意义(P<0.05),其中实验组再血管化发生率显著低于对照组(P<0.05),而两组无心肌梗死和死亡等不良心脏事件发生。结论与常规culotte术式相比,DK mini-culotte术式显著缩短了手术时间、提高了手术成功率、减少造影剂用量并提升最终球囊对吻扩张的完成率,同时能降低血栓等不良事件发生。

Objective To investigate the clinical efficacy of double kissing（DK）mini-culotte stenting in the treatment of coronary bifurcation lesions. Methods Sixty-eight patients with coronary bifurcation lesions diagnosed by coronary angiography at Guangdong Nongken Central Hospital and Affiliated Hospital of Guangdong Medical University were randomly divided into an experimental group and a control group,with 34 cases in each group.DK mini-culotte stenting was used for patients with bifurcation lesions in the experimental group,and patients with bifurcation lesions in the control group were treated with double stenting according to the conventional culotte stenting technique.The success rates of the two groups,the completion of the final kissing balloon dilation,the operation time,the dosage of contrast agent and the incidence rate of main adverse cardiac events during the 6-month follow-up were observed. Results Compared the operation time,the success rate of the operation,the dosage of contrast agent and the completion rate of the final kissing balloon dilation between the experimental group and the control group showed that the differences were statistically significant（P〈0.05）,in which the operation time and the dosage of contrast agent in the experimental group were significantly lower than those of the control group,and the success rate of the operation and the completion rateof the final kissing balloon dilation in the experimental group were significantly higher than those of the control group.The incidence of main adverse cardiac events in the experimental group and the control group was 5.88%and 23.53%respectively in 6-month follow-up,comparison between the two groups showed that the difference was statistically significant（P〈0.05）.The rate of revascularization in the experimental group was significantly lower than that in the control group（P〈0.05）,but no myocardial infarction and death occurred in the two groups. Conclusion Comparing with the conventional culotte stenting,the DK mini-culotte stenting can significantly shorten the operation time,improve the success rate of the operation,reduce the dosage of contrast agent,and improve the completion rate of the final kissing balloon dilation,and reduce the the occurrence of adverse events such as thrombus.