药物洗脱支架联合药物涂层球囊在冠状动脉左主干分叉病变中的应用

The application of drug-eluting stent combined with drug coated balloon in treating coronary lesions located at left main bifurcation site

目的评价药物洗脱支架(DES)联合药物涂层球囊(DCB)治疗冠状动脉左主干(LM)分叉病变的临床效果。方法回顾性分析2016年7月至2017年7月采用DES联合DCB治疗的8例LM分叉病变患者临床资料。8例患者均接受LM和左前降支病变处DES治疗,左回旋支开口处DCB治疗,其中6例手术在血管内超声导引下进行。术后即刻造影评价病变血管通畅情况,术后6个月随访再狭窄率及6个月内严重临床事件发生率。结果 DES联合DCB治疗LM分叉病变再狭窄率低[LM(8.4±5.3)%,左前降支(18.2±5.0)%,左回旋支(30.5±16.5)%]。术后所有患者未发生严重临床事件。结论 DES联合DCB介入治疗LM分叉病变安全有效。

Objective To evaluate the clinical efficacy of drug-eluting stent(DES) combined with drug-coated balloon(DCB) in the treatment of coronary lesions located at the left main(LM) bifurcation site. Methods The clinical data of 8 patients with LM bifurcation lesions, who were treated with DES combined with DCB during the period from July 2016 to July 2017, were retrospectively analyzed. In all 8 patients, both coronary LM and left anterior descending(LAD) branch lesions were treated with DES, and the lesions located at the ostium of left circumflex(LCX) branch were treated with DCB, among whom the operation was performed under the guidance of intravascular ultrasound(IVUS) in 6 patients. Immediate postoperative angiography was adopted to evaluate the patency of the diseased vessels. The follow-up restenosis rate at 6 months after operation and the serious clinical events occurred within 6 months after operation were recorded. Results The restenosis rate of DES combined with DCB for the treatment of coronary lesions located at LM bifurcation site was low. The restenosis rates of LM bifurcation, LAD and LCX lesions were(8.4±5.3)%,(18.2±5.0)% and(30.5±16.5)% respectively. No serious procedure-related complications occurred in all patients. Conclusion DES combined with DCB is a safe and effective interventional treatment for coronary lesions located at LM bifurcation site.