单支架术在冠状动脉左主干病变治疗中的应用评价

Evaluation of the application of single-stenting in patients with left main coronary artery lesions

目的评价冠状动脉左主干(LMCA)病变病人接受单支架术的治疗效果及预后。方法收集2007年1月至2014年3月在苏州大学附属第二医院接受经皮冠状动脉介入治疗(PCI)的53例LMCA病变病人的临床资料,所有入选病人均完成了冠状动脉单支架植入术。随访病人术后1年、术后2年时主要不良心脑血管事件(MACCE)发生情况。结果手术成功率100%。23例在PCI术后1—12月行冠状动脉造影复查,2例发生支架内再狭窄,再狭窄率为8.7%。术后1年、术后2年时总体MACCE发生率分别为7.5%、9.4%。PCI术后1年、2年,SYNTAX积分低、中分组(≤32)和高分组(≥33)间无MACCE生存率比较,差异无统计学意义(分别为90.5%、100.0%,P=0.297;90.5%、90.9%,P=0.931)。结论对经选择的LMCA病变病人,包括部分无保护左主干病变及分叉病变病人,单支架术成功率高,中远期预后良好。

Objective To evaluate the therapeutic effect and prognosis of patients with left main coronary artery(LMCA)lesions underwent one-stent technique.Methods A total of 53 cases of LMCA patients underwent percutaneous coronary intervention(PCI)with one-stent strategy in the Second Affiliated Hospital of Soochow University from January 2007 to March 2014 was recruited.The incidence of major adverse cardiac and cerebrovascular events(MACCE)was recorded after one year and two years followed-up visit.Results All of the recruited patients were successfully implanted one stent.23 cases got angiographic follow-up from one month to twelve months after PCI,and 2 cases had in-stent restenosis with a rate of 8.7%.The incidence of MACCE was 7.5%(one year s follow-up)and 9.4%(two years follow-up).There were no significant differences in no MACCE survival rate after PCI between the low score group,middle score group(≤32)and high score group(≥33)at one year(90.5%and 100.0%,respectively,P=0.297)and two year(90.5%and 90.9%,respectively,P=0.931).Conclusion For patients with selected LMCA lesions,including some unprotected left main lesions and bifurcation disease,single stent treatment has a higher rate of successful procedure with a better medium and long-term prognosis.