无保护左主干病变支架介入治疗后冠状动脉造影随访结果分析

目的观察无保护左主干病变,应用药物洗脱支架介入治疗后冠状动脉造影随访结果,并分析其影响因素。方法选择无保护左主干病变患者150例,其中48例在平均(10.0±7.5)个月进行了冠状动脉造影复查,根据冠状动脉造影显示有无狭窄分为:再狭窄组12例和无再狭窄组36例。结果与无再狭窄组比较,再狭窄组患者随访时最小管腔直径明显减小(2.7±1.0)mm vs (3.5±0.4)mm,P=0.0001]、直径狭窄率明显升高(31.4±26.4)% vs (8.3±5.3)%,P=0.0000]、晚期管腔丢失明显升高(0.8±0.7)mm vs (0.2±0.3)mm,P=0.0000];双支架置入术的再狭窄率明显高于单支架置入术(75.0% vs 13.9%),P=0.0011]。结论左主干远端分叉病变双支架置入术的疗效较差,冠状动脉旁路移植术应作为首选。

Angiographic follow-up results after drug-eluting stents intervention for unprotected left main coronary artery disease

Objective To analyse the influencing factors for restenosis of unprotected left main coronary artery after intervention with drug-eluting stents.Methods From April 2003 to June 2008, 150 patients underwent unprotected left main coronary artery stenting.Of them,48 (32%) were reviewed by coronary angiography after (10.0 ± 7.5) months.Results By comparing restenosis group with non-restenosis group in the follow-up angiographical results,the minimal lumen diameters were(2.7 ± 1.0) mm vs (3.5 ± 0.4) mm,P = 0.0001,the rates of stenosis were(31.4 ± 26.4)% vs (8.3 ± 5.3)%,P = 0.0000,late lumen loss was(0.8±0.7) mm vs (0.2±0.3) mm, P = 0.0000 and stenting technique in the two groups was different significantly.Restenosis rate of the two-stent technique was greater than that of one-stent technique(75.0% vs 13.9%,P = 0.0011).Conclusion The therapeutic efficacy of two-stents implantation for left main coronary artery distal-bifurcation lesion is unsatisfactory and coronary artery bypass grafting should be the first choice.