无保护左主干病变患者经皮介入治疗的即刻及远期疗效分析

目的探讨无保护左主干病变患者经皮冠状动脉介入治疗(PCI)的近、远期疗效。方法解放军总医院2001年12月~2006年8月接受PCI的77例左主干病变的病例资料,2006年8月对上述患者进行随访,包括造影及电话随访。结果即刻成功率100%,无严重术中并发症,住院期间无死亡。术后随访0.5~54(12.95±10.31)个月,其中1例术后6个月行冠状动脉CT检查,支架内无狭窄;20例患者进行了冠状动脉造影检查,1例术后30天出现支架内亚急性血栓;10例分别在1~12个月造影时显示支架内再狭窄,其中4例发生在左主干支架内,其余再狭窄均发生在分叉远端,并分别进行了处理。其余患者进行了电话随访,1例复发心绞痛,接受药物治疗。结论对经过选择的无保护左主干病变患者进行支架置入是可行和安全的,并有良好的近、远期疗效。

Efficacy of percutaneous coronary intervention in treatment of unprotected left main coronary artery disease

Objective To evaluate the in-hospital and long-term efficacy of percutaneous coronary intervention(PCI) in treatment of left main coronary artery disease in selected patients.Methods From December 2001 to August 2006,a total of 77 consecutive patients underwent PCI on left main coronary artery lesions in PLA General Hospital.They received follow-up examination in August 2006.Results The immediate success rate was 100%,without any complication.No patient died in hospital.Mean follow-up period was 0.5-54(12.95±10.31) months after PCI.One patient was confirmed to have no restenosis by coronary CT.Twenty patients were followed up by coronary angiography.Of them,1 presented in-stent subacute thrombosis and 10 presented in-stent restenosis from 1to 12months after PCI.In these patients,4 restenosis occurred within left main coronary artery and others in distal bifurcation.They all were treated.The others were followed up by telephone.One patient had recidivation of angina and was treated with drug.Conclusion For treatment of selective left main coronary artery disease,PCI is safe and feasible.It can bring good in-hospital and long-term outcomes.