小球囊保护冠脉分叉病变分支的临床分析

The Clinical Analysis of Protecting Side Branch with A Small Balloon in Treating Coronary Bifurcation Lesion

目的探索冠脉分叉病变应用主支植入药物洗脱支架同时小球囊保护分支介入策略的临床价值。方法回顾性分析48例冠脉分叉病变用主支植入药物支架同时小球囊保护分支介入策略病例的即时疗效及安全性。结果影像学效果:主支术前的狭窄程度为(86.80%±9.10%),术后的狭窄程度为(0.20%±0.80%),Z=-6.08,P<0.01;分支术前的狭窄程度为(67.10%±20.00%),分支术后的狭窄程度为(27.30%±18.20%),Z=-5.99,P<0.01。临床效果:主要不良心血管事件的发生比例为0。安全性:分支闭塞的比例、禁锢球囊滞留的比例、禁锢导丝滞留的比例均为0,分支保护球囊以(10.00±2.70)atm的压力进行扩张,主支的支架以(15.10±1.80)atm的压力释放可使分支被禁锢的球囊、导丝顺利撤出。结论应用主支植入药物洗脱支架同时小球囊保护分支治疗冠脉分叉病变的即时疗效好、安全性高,但长期的疗效值得进一步探索。

Objective To explore the clinical value of implanting a DES(drug eluting stent)in main vessel anddilating a small external diameter balloon in side branch in treating coronary bifurcation lesion.Methods Forty-eightpatients who underwent this intervention strategy were retrospectively observed to study its short-term effectiveness andsafety.Results The angiographic effectiveness was as follow:Before the operation the degree of main vessel's stenosiswas(86.80%±9.10%),while the degree of main vessel's stenosis was(0.20%±0.80%)after the operation(Z=-6.08,P<0.01).Before the operation the degree of side branch's stenosis was(67.10%±20.00%),while the degree of sidebranch stenosis was(27.30%±18.20%)after the operation(Z=-5.99,P<0.01).The clinical effectiveness was asfollow:No MACEs happened during the operation in this study.The safety was as follow:When the main vessel sentballoon was dilated in(15.10±1.80)atm and the side branch small balloon was dilated in(10.00±2.70)atm,thejailed small balloon and guide-wire in the side branch could be removed smoothly.Conclusion The instant effectivenessand safety of implanting a DES in main vessel and dilating a small balloon in side branch in treating coronary bifurcationlesion is good.But its long-term effectiveness and safety is worth studying further.