药物涂层球囊边支扩张技术在治疗冠状动脉真性分叉病变的安全性和有效性分析

Safety and effectiveness of drug coated balloon dilation technique in the treatment of true bifurcation lesions of coronary arteries

目的通过对比双支架技术和药物涂层球囊(DCB)边支扩张技术在治疗冠状动脉真性分叉病变中的疗效,探讨DCB在真性分叉病变治疗中的安全性和有效性。方法本研究为回顾性研究,共纳入216例经皮冠状动脉介入治疗的冠状动脉真性分叉病变患者。并将患者分为双支架技术组和DCB边支扩张技术组,对比两组1年临床随访期间靶病变血运重建和主要不良心血管事件(MACE)等发生情况。MACE包括术后再发心绞痛、心源性死亡和再发性心肌梗死以及靶血管血运重建。结果两组冠状动脉分叉病变Medina分类方面对比差异具有统计学意义(P<0.05),双支架技术组边支直径明显高于DCB边支扩张技术组,组间比较差异具有统计学意义(P<0.05)。其他临床资料以及冠状动脉分叉病变特征对比两组间对比差异均无统计学意义。两组1年随访期间,临床结局对比差异均无统计学意义。经过倾向评分配比后,两组在临床资料以及冠状动脉分叉病变特征方面组间比较差异均无统计学意义;两组在1年随访期间,在预期主要研究终点和次要研究终点发生方面比较差异均无统计学意义。结论本研究显示,在1年临床随访期间,DCB边支扩张技术在治疗冠状动脉真性分叉病变方面,与双支架技术具有相似的有效性和安全性。

AIM To compare the efficacy of double-stent technique and drug-coated balloon(DCB)side-branch dilation technique in the treatment of true coronary bifurcation lesions,and to explore the safety and effectiveness of DCB in the treatment of true coronary bifurcation lesions.METHODS This study was a retrospective study.A total of 216 patients with true coronary bifurcation after percutaneous coronary intervention were included.The patients were divided into two groups:double-stent technique group and DCB side-branch dilation technique group.The target lesion revascularization and major adverse cardiovascular events(MACE)were compared between the two groups during the 1-year clinical follow-up.MACE includes recurrent angina pectoris,all-cause death,recurrent myocardial infarction and target vessel revascularization.RESULTS The difference in Medina classification of coronary bifurcation lesions between the two groups was statistically significant(P<0.05).The diameter of the side branch in the double stent technique group was significantly higher than that in the DCB side branch dilation technique group,and the difference between the groups was statistically significant(P<0.05).There was no statistically significant difference between the two groups in other clinical data and the characteristics of coronary artery bifurcation lesions.During the one-year follow-up period,there was no statistically significant difference in clinical outcomes between the two groups.After propensity score matching,there was no statistically significant difference between the two groups in terms of clinical data and characteristics of coronary bifurcation lesions;During the one-year follow-up period,there was no statistically significant difference in the expected primary and secondary study endpoints between the two groups.CONCLUSION During the 1-year clinical follow-up period,DCB side-branch dilation technique has similar efficacy and safety with double-stent technique in the treatment of true coronary bifurcation lesions.