单支架与双支架术式分支球囊保护策略对冠状动脉前降支分叉病变患者的疗效比较研究

背景冠状动脉前降支分叉病变发生率及术后不良心血管事件发生率高,而明确合适的球囊保护策略对改善患者预后具有重要意义。目的比较单支架与双支架术式的分支球囊保护策略对冠状动脉前降支分叉病变的疗效。方法选取2015年1月—2018年1月都江堰市医疗中心收治的冠状动脉前降支真性分叉病变患者260例,根据分支球囊保护策略分为观察组(n=108)和对照组(n=152)。在基础治疗上,对照组患者采用双支架术式分支球囊保护策略,观察组患者采用单支架术式分支球囊保护策略。记录两组患者手术时间,球囊使用数量,支架植入数量,导丝使用数量,对比剂用量,术中分支血管慢血流、血流限制性夹层/分支血管闭塞,术后心肌梗死、心肌酶谱增高、主支及分支血管TIMI血流3级发生率,观察随访期间两组患者不良心脑血管事件及靶血管再次血运重建方式。结果观察组患者手术时间短于对照组,球囊使用数量、支架植入数量、导丝使用数量、对比剂用量低于对照组(P0.05)。两组患者术中分支血管慢血流、血流限制性夹层/分支血管闭塞发生率及术后心肌梗死,心肌酶谱增高,主支、分支血管TIMI血流3级,再发心绞痛,主分支血管再狭窄,非致死性心肌梗死发生率比较,差异均无统计学意义(P0.05)。观察组患者再狭窄程度高于对照组(P0.05)。两组患者再次行经皮冠状动脉介入治疗、冠状动脉旁路移植术率比较,差异无统计学意义(P0.05)。结论单支架及双支架术式的分支球囊保护策略治疗冠状动脉前降支真性分叉病变患者效果较好,与双支架术式比较,单支架术式可缩短患者手术时间,减少球囊使用数量、支架植入数量、导丝使用数量及对比剂用量,但会增加患者再狭窄程度。     

改良Y支架术与reverse crush支架术治疗冠状动脉分叉病变的疗效比较

目的对比改良Y支架术与reverse crush支架术治疗冠状动脉分叉病变的临床疗效。方法将65例冠状动脉分叉病变患者随机分为两组,分别行改良Y支架术（改良组）和reverse crush支架术（对照组）治疗,观察两组疗效和随访1年主要心脏不良事件发生率。结果改良组手术时间、X线曝光时间短于对照组（P均〈0．01）;造影剂和球囊用量少于对照组（P均〈0．01）,最终球囊对吻成功率更高,但无统计学差异（P〉0．05）;6～9个月造影随访,改良组分支血管再狭窄率低于对照组（P〈0．01）。1年随访结束,对照组心脏不良事件发生率高于改良组,但无统计学差异（P〉0．05）。结论改良Y支架术较teverse crash支架术操作简单、费时少,具有更低的分支再狭窄率,有减少随访1年临床心脏不良事件的趋势,推荐临床优先选用。     

无球囊对吻单支架植入术治疗分叉病变的近期疗效

目的：通过比较分叉病变经皮冠状动脉介入治疗术（PCI）3种处理方法的近期疗效,探讨最简单处理方法-无球囊对吻单支架植入术的安全性及有效性。方法：入选主支血管即刻造影成功PCI患者81例,分成三组：无球囊对吻单支架组,主支血管植入药物洗脱支架（DES）后,边支血管不予任何处理;球囊对吻单支架组,主支植入DES后,边支血管予球囊对吻扩张;球囊对吻双支架组,主支和边支均植入DES后,予球囊对吻。6个月临床随访观察主要不良心血管事件（MACE）发生情况,以及定量冠状动脉造影（QCA）评价血管再狭窄率和血管狭窄程度。结果：术后6个月,虽然三组间边支血管开口狭窄程度[（65．3±19．6）％、（59．9±17．7）％和（46．8±11．5）％,P〈0．001]有显著性差异,但是三组间MACE发生率（12．1％、14．8％和19．0％,P〉0．05）和主支血管再狭窄率（6．1％、7．4％和9．5％,P〉0．05）差异无显著性。结论：主支血管即刻造影成功PCI患者3种处理方法的近期临床疗效并无显著性差异,提示无球囊对吻单支架植入术治疗分叉病变安全有效。     

经桡动脉途径行改良球囊挤压支架术治疗冠状动脉分叉病变

目的 分析经桡动脉途径应用改良球囊挤压支架术治疗冠状动脉分叉病变的可行性及成功率。方法 经桡动脉途径造影证实血管病变处有直径>2.5 mm分支,分支起始部有>70%狭窄的患者17例,应用改良球囊挤压支架术治疗分叉病变,观察病变血管狭窄程度、斑块移位及球囊对吻扩张成功率和随访效果。结果 分叉病变中均成功植入雷帕霉素药物洗脱支架,15例患者行同步对吻球囊技术进行后扩张, 术后前向血流均为TIMI Ⅲ级,所有患者未发生边支急性闭塞、支架内血栓、心源性休克、死亡等并发症。结论 冠心病分叉病变介入治疗中,经桡动脉途径通过6F或7F指引管完成改良球囊挤压支架术可获得满意结果,支架间隙小或无,再狭窄率低。     

血管内超声指导对于冠状动脉真性分叉病变介入治疗长期预后的影响

目的研究血管内超声（intravascular ultrasound,IVUS）指导对于冠状动脉真性分叉病变植入药物洗脱支架（drug eluting stent,DES）长期预后的影响。方法通过分析2005年10月至2010年3月DK—Crush系列随机对照研究入选735例原位冠状动脉真性分叉病变植入DES患者,应用倾向评分匹配临床和造影特征,165例IVUS指导和165例冠状动脉造影指导患者纳入研究,比较两组患者的长期预后。结果两组临床基线资料和造影特征比较,差异无统计学意义（P〉0．05）。IVUS指导组更常见选择双支架策略（P=0．007）,IVUS指导组主支血管（MV）和分支血管（SB）的最大支架直径和支架总长度以及分支血管支架个数显著超过常规造影指导组;介入治疗后QCA分析显示,IVUS指导组分支血管参考血管直径（RVD）和即刻获得以及主支血管近端和分支血管最小管腔直径（MLD）显著超过造影指导组。12个月随访发现两组心脏死亡、靶病变重建（TLR）和主要心血管事件（MACE）比较,差异无统计学意义（P〉0．05）。然而,IVUS指导组晚期支架内血栓和急性心肌梗死发生率显著低于造影指导组,差异有统计学意义（0．6％ vs.4．8％。P=0．04;1．8％ vs.6．7％,P=0．03）。结论IVUS指导冠状动脉真性分叉病变植入DES可以显著减低晚期支架内血栓和由此引起急性sT段抬高心肌梗死发生率而改善长期预后。     

冠状动脉支架术后临床症状影响因素分析

目的 :探讨冠状动脉内支架植入后影响临床症状的因素。方法 :对196例植入冠状动脉支架的病人随访6个月 ,比较出现心前区不适症状病人与未出现症状者间的临床特征及病变血管类型。结果 :196例病人中有42例 ( 2 1.4% )出现心前区不适症状。临床资料中 ,糖尿病、血脂异常、吸烟、高文化程度方面因素有症状组明显高于无症状组 ,两组比较有统计学意义(P <0 .0 5 )。影像学方面 ,多支病变、分叉病变、弥漫性病变、长病变及严重狭窄病变有症状组与无症状组比较有统计学意义 (P <0 .0 5 )。结论 :糖尿病、血脂异常、吸烟、高文化程度以及多支病变、分叉病变、弥漫性病变、病变长度 >15mm、狭窄程度 >99%者 ,可以增加冠心病病人冠状动脉支架术后心前区不适症状的复发。     

应用切割球囊结合支架术治疗冠状动脉分叉处病变89例

目的 :评价经皮冠状动脉腔内切割球囊成形术 （PTCBA）结合支架术治疗冠脉分叉处病变的安全性及疗效。方法 :对 89例冠心病患者主支病变应用 PTCBA预扩张后置入支架、分支病变单行 PTCBA而不置入支架 ,观察其冠脉病变特点、手术过程相关因素、手术成功率、并发症和近、中期随访结果。结果 :89例患者中分叉处病变位于前降支 /对角支占 71% ,回旋支 /钝圆支占 2 5 % ,右冠脉 /后降支或后侧支占 4%。对分支血管行 PTCBA后 1例因残余狭窄 >5 0 %而植入支架 ,1例因并发轻度钙化且分支成角较大切割球囊未通过 ,改用常规 PTCA球囊扩张成功。病变 PTCBA成功率达 97.8% ;无院内死亡、急性心肌梗死 （AMI）、急性心包填塞及急诊冠脉搭桥术等严重并发症。对手术成功的 87例术后临床随访 3～ 2 6个月 ,无死亡及 AMI等心脏事件发生。临床心绞痛复发率 17.2 %。复查冠脉造影 （CAG）率 5 6.3 % ,示 49处分叉病变主支支架内再狭窄率 14.3 % ,分支血管再狭窄率 18.4%。结论 :PTCBA结合支架术治疗冠脉分叉处病变是一种安全、有效的介入治疗技术 ,其成功率高、并发症少 ,近、中期疗效满意     

Crush及Culotte术式治疗冠状动脉分叉病变的主要不良心脏事件风险比较

目的研究Culotte techniques(DK-Mini-Culotte)双支架术及Crush techniques(DKMini-Crush)双支架术式治疗冠状动脉分叉病变主要不良心脏事件发生情况。方法纳入2015年7月至2019年1月中国科学技术大学附属第一医院收治的221例冠状动脉分叉病变患者,按照手术方式分两组,其中观察组行DK-Mini-Crush术(154例),对照组接受DK-Mini-Culotte术(67例)。比较两组造影特征及经皮冠状动脉介入治疗(PCI)情况(包括主支病变长度、分支病变长度、主支支架长度、分支支架长度、平均支架植入数、手术时间、造影剂总量、住院天数及病变分布特点、手术成功率、最终对吻球囊扩张成功率、主支即刻造影成功率、分支即刻造影成功率),分析两组术后主要不良临床事件发生情况。结果两组主支病变长度、分支病变长度、主支支架长度、分支支架长度、平均支架植入数、手术时间、造影剂总量、住院天数及病变分布情况、手术成功率、最终对吻球囊扩张成功率、主支即刻造影成功率、分支即刻造影成功率比较差异均无统计学意义(P> 0.05)。观察组术后支架内再狭窄率为1.30%,显著低于对照组的7.46%(χ2=3.948,P <0.05),出血、再发心绞痛、心源性死亡、病变血运重建所占比例较对照组比较差异均无统计学意义(P> 0.05)。结论 DK-Mini-Crush术与DK-Mini-Culotte术治疗冠状动脉分叉病变最终对吻球囊扩张成功率均较高,均具有良好的临床及造影结果,但后者支架内再狭窄率相对较高,临床应引起足够重视。     

冠状动脉多支病变支架术的临床应用

目的旨在分析冠状动脉多支病变支架术的效果。方法168例冠状动脉造影异常者按单支和多支病变分两组,单支组56例,多支组112例,支架置入率分别为58.9%和52.7%,血管狭窄70%以上置入支架。结果两组年龄和支架长度有显著性差异,性别、吸烟、高血压、糖尿病、高血脂、冠状动脉并发症、支架术失败率以及随访心脏事件和再狭窄率均无差异。结论冠状动脉多支病变支架置入术安全有效。     

64排CT冠状动脉斑块分析对冠状动脉直接支架术指导作用的研究

目的 探讨64排CT冠状动脉斑块分析对冠状动脉直接支架术的指导意义.方法 连续入选接受64排CT冠状动脉成像（CTA）并冠状动脉直接支架术治疗的患者42例,置入支架44枚.根据支架释放后有无残余狭窄分为2组,组间对比64排CT冠状动脉成像所示斑块的性质、斑块的CT值、钙化长度、横断面最大钙化面积.结果 残余狭窄组患者斑块的最大CT值大于无残余狭窄组（P＜0.01）.Logistic回归分析显示,当斑块的CT值达到648～679时,支架释放时出现残余狭窄的概率为70％～90％.结论 冠状动脉直接支架术支架释放后出现残余狭窄与斑块的最大CT值有关,当斑块有明显大的CT值时,采用直接支架术需谨慎.     

Drug‐eluting stents in bifurcation lesions: To stent one branch or both?

OBJECTIVES: The objective of this study was to compare two techniques to treat bifurcation lesions: a single drug-eluting stent (DES) implanted in the main branch combined with balloon dilatation for the side branch vs. stenting of both branches (double stent). BACKGROUND: Percutaneous coronary intervention in coronary bifurcation lesions remains challenging. Although DES reduce restenosis in lesions, the double stent procedure has not shown clear advantages over a single stent with balloon dilation. METHODS: Fifty-three symptomatic patients with true bifurcation lesions were treated using either the double stent technique (n = 25) or one stent in the parent vessel plus balloon angioplasty of the side branch (n = 28). Procedural results and major adverse cardiac event rates (MACE: cardiac death, myocardial infarction, target vessel revascularization (TVR)) were compared. RESULTS: Angiographic procedural success (residual stenosis <30% in both branches) was 75% in the single stent group and 100% in the double stent group (P = 0.01). All differences were due to residual stenosis of the side branch. Clinical follow-up (6-18 months) was available for all patients; 90.5% of patients had a coronary angiography or nuclear stress test. Three patients (11%) in the single stent group and two (8%) in the double stent group had ischemia-driven TVR (P = NS). Asymptomatic angiographic restenosis (>50% diameter stenosis) in the ostium of the side branch was seen in two patients in the double-stent group. At 6 months, MACE-free was comparable between groups (89.3% vs. 88%, P = 0.7). CONCLUSIONS: When treating bifurcation lesions with sirolimus-eluting stents, restenosis following a single stent procedure is comparable to stenting both parent and side branch vessels. Thus, stenting the main-branch lesion, coupled with balloon angioplasty in the side branch, produces a high success rate and good clinical outcomes at 6 months.     

EXCEL支架在冠状动脉分叉病变应用的研究

目的:探讨EXCEL雷帕霉素洗脱支架治疗冠状动脉分叉病变的安全性和有效性。方法:共56例病人有57处冠状动脉真性分叉病变(其中前降支/对角支30例,左回旋支/钝缘支17例,右冠脉/后降支8例,前降支/回旋支1例)接受主支血管EXCEL雷帕霉素洗脱支架和分支血管球囊扩张术,回顾性分析其结果。结果:手术即刻成功率100%,住院期间无主要不良心脏事件(MACE)发生。6~18个月随访[临床随访率100%,造影随访38例(67.9%)]结果显示:MACE发生1例(1.8%,1/56),为造影证实的支架内再狭窄70%,并实施了再次PCI。造影再狭窄率为5.3%(2/38)。结论:EXCEL雷帕霉素洗脱支架治疗冠状动脉分叉病变安全,有效。     

Coronary bifurcation lesions: to stent one branch or both?

OBJECTIVE: The purpose of this study was to evaluate two different stent placement techniques for bifurcation lesions: 1) stenting of the main branch and balloon dilatation of the sidebranch versus 2) stenting of both branches. BACKGROUND: Percutaneous coronary intervention (PCI) of coronary bifurcation lesions remains challenging, and limited information is available regarding whether stent placement is necessary in both branches of the bifurcation using bare-metal stents. Methods. We prospectively followed all patients who underwent PCI for symptomatic bifurcation lesions at our center. All patients were carefully followed for subsequent clinical events. RESULTS: Between March 2001 and November 2002, a total of 50 patients were treated with either stenting of both vessels (double stent group; n = 32) or stenting of the parent vessel and balloon angioplasty of the sidebranch (single stent group; n = 18). Optimal angiographic success was 87.5% in the single stent group and 100% in the double stent group (p = 0.1). The post-procedure percent diameter stenosis of the sidebranch vessel was significantly higher in the single stent group (18 +/- 25% versus 4 +/- 8%; p = 0.005). At 6 months, the incidence of clinically driven repeat target lesion revascularization was 37.6% with 2 stents as compared to 5.6% using 1 stent (p = 0.01). Angiographic restenosis was documented in 40.6% using 2 bifurcation stents, as compared to 11% when using 1 stent (p = 0.05). By multivariable analysis adjusted for baseline differences, stenting the sidebranch was a borderline predictor for major adverse cardiac events at 6 months (odds ratio = 10.3; 95% confidence interval, 0.9-116; p = 0.053). CONCLUSION: For the treatment of true bifurcation lesions, a strategy of stenting both vessels using bare metal stents seems to be associated with worse long-term results, as compared to stenting only the parent vessel.     

A randomized comparison of balloon angioplasty and stent implantation in the percutaneous treatment of coronary bifurcations

OBJECTIVE: A prospective randomized multicentre pilot trial, comparing stenting with balloon angioplasty as a treatment for coronary lesions, located in a bifurcation was performed. METHODS AND RESULTS: After balloon dilatation, with a < 30% residual stenosis in the main vessel and < 50% residual stenosis in the side branch, patients were randomized to stay in a "balloon-only" group or to stenting. The stents used were the AVE S 670 for the main vessel and the Bestent, if needed, for the side branch. The primary end point was the incidence of major adverse cardiac events (MACE) at 6 months, secondary end points were in-hospital MACE, acute angiographic results, use of materials and duration of the procedure. One hundred eleven patients were randomized: 55 in the balloon group, 56 in the stent group. No differences in MACE-rates were found at 6 months (22% versus 20%, p = 0.78). The target vessel revascularization rate was 16% in the balloon group and 12.5% in the stent group (p = 0.56). The acute angiographic results were significantly better in the stent group (residual stenosis 8% versus 26% [p < 0.05]). More materials were used, with a near doubling of the duration of the procedure in the stent group (p < 0.05). CONCLUSIONS: Although stenting resulted in better immediate angiographic results during percutaneous treatment of lesions located in a bifurcation, as compared to balloon angioplasty alone, clinical events were comparable in the two treatment arms.     

Acute and long-term results of bifurcation stenting (from the Coroflex Registry)

Angioplasty of bifurcation lesions represents a continuing challenge. A total of 421 consecutive patients were prospectively followed in a registry on bifurcation stenting with a high-end bare metal stent (Coroflex, BBraun, Berlin, Germany), allowing side branch percutaneous transluminal coronary angioplasty through the stent struts without distraction of the main vessel stent from the vessel wall or other distortions. This approach obviated the 2-wire technique and kissing balloons. Detailed data, including lesion location, stenosis morphology, procedural success, and hospital and follow-up major adverse cardiac events (MACEs; acute myocardial infarction, death, revascularization, hospitalization due to angina), were collected from 6 European centers. Of the patients, 60% had stable angina, 23% had unstable angina pectoris/non-ST-elevation myocardial infarction, and 17% had ST-elevation myocardial infarction. In 17% of patients, the main vessel alone was stented; in 71%, stenting of the main vessel was complemented by side branch percutaneous transluminal coronary angioplasty. Technical success (residual stenosis <50%) in the 2 branches was achieved in 90% (main vessel in 99%). The rate of MACEs at discharge was 2%. After 6 months, 17% of patients had undergone target lesion revascularization or coronary artery bypass grafting. The total 6-month MACE rate was 22%. In conclusion, successful bifurcation stenting with a low MACE rate is possible in most patients using a simplified approach with a dedicated high-end bare metal stent.     

Stenting of bifurcation lesions: a rational approach

The occurrence of stenosis in or next to coronary bifurcations is relatively frequent and generally underestimated. In our experience, such lesions account for 15%-18% of all percutaneous coronary intervention > (PCI). The main reasons for this are (1) the coronary arteries are like the branches of a tree with many ramifications and (2) because of axial plaque redistribution, especially after stent implantation, PCI of lesions located next to a coronary bifurcation almost inevitably cause plaque shifting in the side branches. PCI treatment of coronary bifurcation lesions remains challenging. Balloon dilatation treatment used to be associated with less than satisfactory immediate results, a high complication rate, and an unacceptable restenosis rate. The kissing balloon technique resulted in improved, though suboptimal, outcomes. Several approaches were then suggested, like rotative or directional atherectomy, but these techniques did not translate into significantly enhanced results. With the advent of second generation stents, in 1996, the authors decided to set up an observational study on coronary bifurcation stenting combined with a bench test of the various stents available. Over the last 5 years, techniques, strategies, and stent design have improved. As a result, the authors have been able to define a rational approach to coronary bifurcation stenting. This bench study analyzed the behavior of stents and allowed stents to be discarded that are not compatible with the treatment of coronary bifurcations. Most importantly, this study revealed that stent deformation due to the opening of a strut is a constant phenomenon that must be corrected by kissing balloon inflation. Moreover, it was observed that the opening of a stent strut into a side branch could permit the stenting, at least partly, of the side branch ostium. This resulted in the provocative concept of "stenting both branches with a single stent." Therefore, a simple approach is currently implemented in the majority of cases: stenting of the main branch with provisional stenting of the side branch. The technique consists of inserting a guidewire in each coronary branch. A stent is then positioned in the main branch with a wire being "jailed" in the side branch. The wires are then exchanged, starting with the main branch wire that is passed through the stent struts into the side branch. After opening the stent struts in the side branch, kissing balloon inflation is performed. A second stent is deployed in the side branch in the presence of suboptimal results only. Over the last 2 years, this technique has been associated with a 98% angiographic success rate in both branches. Two stents are used in 30%-35% of cases and final kissing balloon inflation is performed in > 95% of cases. The in-hospital major adverse cardiac events (MACE) rate is around 5% and 7-month target vessel revascularization (TVR) is 13%. Several stents specifically designed for coronary bifurcation lesions are currently being investigated. The objective is to simplify the approach for all users. In the near future, the use of drug-eluting stents should reduce the risk of restenosis.     

单纯药物涂层球囊策略治疗冠状动脉分叉病变分支血管的临床观察

目的观察单纯应用药物涂层球囊治疗冠状动脉分叉病变的安全性及有效性。方法入选我院心内科31例分叉病变患者(主支狭窄50%,分支开口狭窄70%;分支血管参考直径≥2mm),单纯应用药物涂层球囊处理分支血管,观察手术成功率、分支血管血流情况及并发症发生率,术后9个月行冠状动脉造影检查,记录随访过程中不良心血管事件(MACE)的发生情况。结果 31例患者33个分叉病变中位于前降支/对角支占57.58%,回旋支/钝缘支占30.30%,右冠状动脉/后降支或左室后支占12.12%。31例患者均成功完成分叉病变介入治疗,手术成功率100%,并且全部患者均经桡动脉途径完成。其中2列患者出现分支血管夹层(1例TIMI血流2级)进行补救性药物洗脱支架植入。围手术期及术后临床随访(门诊或电话随访),无死亡或心肌梗死等主要心脏不良事件发生。74.19%的患者完成了冠状动脉造影复查,仅1例行靶病变再次血运重建(TLR)。分支晚期管腔丢失(LLL)为(0.13±0.25)mm。结论单独药物涂层球囊策略处理冠状动脉分叉病变分支血管是安全有效的。     

国产雷帕霉素长支架临床应用与疗效评价

目的评价国产雷帕霉素长支架对弥漫性长病变的疗效与安全性。方法选择2006年6月至2008年2月长海医院347例冠心病患者,并根据置入支架数目分组为单个支架组（22-36mm）及重叠支架组（〉36mm）;根据置人支架长度分4组：22-36mm、37-59mm、60-80him和〉80mm组。观察支架置入后对分支血管的即刻影响、术后心电图变化和术后1周内心肌肌钙蛋白的变化,并且随访术后的临床症状和主要不良心血管事件（MACE）。结果①总的手术成功率达98．9％,总的急性并发症发生率为6．1％。住院期间MACE发生率达14．1％,30d内MACE发生率5．4％。②重叠支架组（〉36mm）术后肌钙蛋白I（TNI）显著高于单个支架组（22-36mm）：6．0％比1．1％（P〈O．05）;住院期间MACE发生率也明显高于单个支架组：11．6％比5．6％（P〈0．05）;30d内MACE发生率差异无统计学意义。③支架长度〉60mm组发生围手术期并发症及MACE事件明显高于22-36mm组（P〈0．05）,其余组问差异无统计学意义。结论国产雷帕霉素药物支架治疗弥漫性长病变即刻及近期疗效可靠、安全。重叠支架组及置入支架长度〉60mm明显增加术后心肌损伤标志物释放,增加围手术期非Q波心肌梗死的发生率及住院期间MACE事件发生率。     

主支支架加边支预埋球囊治疗冠状动脉分叉病变的疗效及安全性观察

目的 探讨主支支架加边支预埋球囊治疗冠状动脉分叉病变的临床疗效及手术安全性.方法 以江苏省徐州市中心医院2012年10月至2013年7月收治的冠状动脉分叉病变患者86例为研究对象,采用主支支架加边支预埋球囊术进行治疗.依据研究组患者的基线资料特点,选取行单导丝边支保护的60例边支病变患者为对照组.术后,对比评价两组患者的介入治疗成功率、并发症发生率以及随访1年后的心肌梗死溶栓试验（thrombolysis in myocardial infarction,TIMI）血流分级、TIMI心肌灌注（TIMI myocardial perfusion,TMP）血流分级等.结果 术后,研究组和对照组的介入治疗成功率分别为98.84％和85.71％,并发症发生率分别为1.16％和11.11％,组间比较差异具有统计学意义（P＜0.05）.随访1年期间,研究组的主要心血管事件发生率低于对照组,差异具有统计学意义[6.98％（6/86） vs.31.75％（20/63） P＜0.05];TIMI血流分级、TMP血流分级以及右心室舒张末期内径和右心室射血分数均优于对照组,差异具有统计学意义（P＜0.05）.结论 主支支架加边支预埋球囊可提高冠状动脉分支病变患者的介入治疗成功率,降低并发症的发生率,血运重建效果良好,具有较好的远期疗效.