【摘要】 目的:评价T支架技术治疗分叉病变的临床效果。方法:回顾性分析从2004年4月到2006年1月我院对分叉病变连续行T支架技术47例患者临床情况。结果:患者基线特点:年龄(59.2±10.8)岁;性别:男性89.4%;既往心肌梗死27.7%;既往经皮冠状动脉介入治疗(PCI)19.1%;糖尿病23.4%;左心室射血分数0.48±0.34。病变基线特点:病变位置:左主干分叉42.6%、前降支和对角支53.2%、回旋支和钝缘支4.3%;主支参照血管直径(3.43±0.51)mm;边支参照血管直径(2.85±0.19)mm;主支病变长度(17.6±10.6)mm;边支病变长度(13.2±7.6)mm。经股动脉入径59.6%;置入药物洗脱支架56.4%;主支支架释放压力(14.5±2.8)atm(1 atm=101.325 kPa);边支支架释放压力(12.3±2.5)atm;对吻球囊技术(kissing balloon) 89.4%。支架置入成功率100%。主要心脏不良事件(MACE)6例(13%);死亡1例(2.1%),因支架内亚急性血栓形成;急性心肌梗死2例(4.3%),造影证实为支架内亚急性血栓形成,行急诊PCI治疗;靶病变再次血管成形术5例(10.6%),其中2例因支架亚急性血栓、2例因再狭窄行再介入治疗,1例因再狭窄行冠状动脉旁路移植术。6个月临床随访91.5%,造影随访29.8%,再狭窄率21.4%。结论:T支架技术治疗分叉病变操作成功率很高,但具有一定风险。更多还原

【Abstract】 Objective:To evaluate the long term outcome of T-stent technique for true bifurcation lesions. Methods:Retrospective analysis of consecutive 47 patients implanted T-stents was carried out from April 2004 to January 2006 in Fuwai Hospital. Results:Baseline features of patients were:age 59.2±10.8,male 89.4%,OMI 27.7%,diabetes 23.4% and LVEF (48.0+33.8)%.Baseline features of lesions were:LM bifurcation 42.6%,LAD/D 53.2% and LCX/OM 4.3%;Reference vessel diameter in main and branch vessels was 3.43±0.51 mm and 2.85±0.19 mm,respectively.Lesion length in main and branch vessels was 17.6±10.6 mm and 13.2±7.6 mm,respectively.Transfemoral approach 59.6%,DES implantation 56.4%,procedure success rate 100%.MACE in 6 cases(13%),1 death due to subacute in-stent thrombosis(2.1%),2 AMI due to subaeute in-stent thrombosis(4.3%),5 TLR(10.6%)including 4 re-PCl and 1 CABG.Six month clinical follow- up rate was 91.5%,six month angiogram follow-up rate was 29.8%,restenosis rate was 21.4%. Conclusion:Procedure success rate of T-stent technique for true bifurcation lesion was high,but the risk of this technique needs to be considered.更多还原