药物洗脱支架治疗无保护左主干病变疗效观察

目的：评价药物洗脱支架治疗无保护左主干（LMCA）病变的安全性和临床疗效。方法：回顾性分析2004年1月～2006年12月完成的49例无保护左主干病变药物洗脱支架置入术。结果：49例无保护LMCA病变全部成功置入支架，共置入61枚药物洗脱支架，直接支架置入术10例（20．4％），39例（79．6％）行球囊预扩张后置入支架；远端分叉部位病变双支架置入12例（24．5％）。住院期间死亡2例（4．1％），无其他主要心血管事件发生；44例（89．8％）完成门诊及电话随访，平均随访（14±6）个月，术后6～12个月完成冠脉造影随访16例（32．7％），随访期间3例死亡（6．1％），1例死于脑卒中，2例心原性猝死，分别为术后7个月及12个月。随访期间主要心血管事件发生率为6．1％（3／49）。结论：药物洗脱支架治疗经选择的LMCA病变是安全可行的，有较理想的近期和远期疗效。

Clinical results of drug-eluting stent implantation in unprotected left main

Objective：To evaluate the safety and efficacy of percutaneous coronary intervention with drug eluting stem （DES） in unprotected left main coronary arteries. Methods：From January 2004 to December 2006, 49 patients with un-protected left main stenosis were treated with drug eluting stents and were retrospectively analyzed. 61 drug eluting stents were successfully implanted in 49 unprotected left main diseases. Directing stenting was performed in 10 patients（20.4%）, pre-dilation in 39 patients （79.6%）, bifurcation lesion with two stent-technique in 12 patients （24.5%）.Results： There were 2 deaths during hospitalization. 44 patients（89.8%）had been clinically followed up in （14±6）months duration.Angio-graphic follow-up had been performed in 16 （32.7%）patients.There were 3 deaths during follow-up,one died of stroke and 2 for suddend death.The major cardiac event rate during follow-up was 6.1%（3/49）. Conclusion：Drug eluting stent is safe when selectively used in unprotected LMCA disease and can achieve optimal acute and long-term clinical results.