单支架与双支架置入治疗冠状动脉真性分叉病变临床分析

目的 探讨单支架与双支架置入治疗冠状动脉真性分叉病变的疗效。方法 71例冠状动脉真性分叉病变患者随机分为行单支架置入者（35例）与行双支架置入者（36例）,术中置入主支支架后根据分支的术中表现再进行分组调整;观察2组围手术期心肌梗死、心源性死亡、急性心肌梗死、再次靶血管血运重建率、节段内血栓发生率及再狭窄率。结果主支支架置入后,3例由单支架组调至双支架组,5例由双支架组调至单支架组;64例完成1a随访,其中行单支架置入治疗33例,双支架置入治疗31例;2组均无围手术期心肌梗死、心源性死亡;单支架组急性心肌梗死、再次靶血管血运重建率及节段内血栓发生率（3.03%、3.03%、3.03%）与双支架组（3.22%、3.22%、6.44%）比较差异无统计学意义（P〉0.05）;单支架组分支血管的节段内再狭窄率（30.30%）高于双支架组（9.68%）（P〈0.05）。结论 双支架置入治疗部分冠状动脉真性分叉病变可降低节段内再狭窄率。

Single stenting versus double stenting for true coronary bifurcation lesions

Objective To explore the clinical effects of single or double stenting strategy for true coronary bifurcation lesions. Methods Seventy-one patients with true coronary bifurcation lesions were randomly divided into single stenting group （n= 35） and double stenting group （n= 36）, and some patients were adjusted the stenting strategy and redivided into groups according to the intraoprative demonstrations after stenting in the main branch. The perioperative myocardial infarction, cardiac death, acute myocardial infarction, revaseularization of target vessels, stent thrombosis and restenosis rate were observed in two groups. Results After stenting in the main branch, 3 patients were transmitted from single stenting group to double stenting group and 5 patients were transmitted from double stenting group to single stenting group. Sixty-four patients completed one-year follow-up survey, in which 33 underwent single stenting and 31 underwent double stenting. No perioperative myocardial infarction or caidiac death occured in both two groups. There were no obvious signifieanees in the incidence of acute myocardial infarction, target vessel revascularization rate and stent thrombosis rate between single stenting group （3.03%, 3.03%, 3.03%） and double stenting group （3.22%, 3.22%, 6.44%） （P〉0.05）. The restenosis rate was significantly higher in single stenting group （30.30%） than that in double stenting group （9.68%） （P〈0. 05）. Conclusion Double stenting can reduce the restenosis rate for true coronary bifurcation lesions.