冠脉分叉病变的介入治疗现状

冠状动脉分叉病变的介入治疗由于存在边支堵塞的风险在技术应用上受到限制。与非分叉病变相比,分叉病变的介入治疗有相对低的手术成功率、更大的手术花费和更高的再狭窄率。药物涂层支架的使用,使主支的再狭窄发生率有所下降,但边支开口的再狭窄和分叉病变长期预后中存在的再狭窄问题依然存在。在药物涂层支架时代,已出现双支架的治疗策略。通常根据分叉病变的不同类型采用不同的治疗技术,主支支架术加必要时边支支架术是目前通常采取的技术策略。

Status of Percutaneous Coronary Intervention for Bifurcation Lesions

Pereutaneous coronary intervention（PCI） for bifurcation lesions is technically limited by the risk of side branch occlusion. In comparison with non-bifurcation interventions, bifurcation intervention have a lower rate of success, higher costs and higher rate of re-stenosis. The recent introduction of drug-eluting stent（DES） has resulted in reduced incidence of main vessel restenosis. However, the residual stenosis at ostial side-branch and long-term re-stenosis is still insurmountable. In the era of DES, techniques employing two stents have emerged. Usually, different treatment techniques will be elected by the different type of coronary bifurcation lesions. Stenting of the main vessel with provisional side branch stenting seems to be the prevailing approach.