药物洗脱支架治疗无保护左主干病变疗效观察.docVIP

药物洗脱支架治疗无保护左主干病变疗效观察[摘要] 目的：评价药物洗脱支架治疗无保护左主干（LMCA）病变的安全性和临床疗效。方法：回顾性分析2004年1月～2006年12月完成的49例无保护左主干病变药物洗脱支架置入术。 结果：49例无保护LMCA病变全部成功置入支架，共置入61枚药物洗脱支架，直接支架置入术10例（20.4%），39例（79.6%）行球囊预扩张后置入支架；远端分叉部位病变双支架置入12例(24.5%)。住院期间死亡2例（4.1%），无其他主要心血管事件发生；44例（89.8%）完成门诊及电话随访，平均随访（14±6）个月，术后6～12个月完成冠脉造影随访16例（32.7%），随访期间3例死亡（6.1%），1例死于脑卒中，2例心原性猝死，分别为术后7个月及12个月。随访期间主要心血管事件发生率为6.1%（3/49）。结论：药物洗脱支架治疗经选择的LMCA病变是安全可行的，有较理想的近期和远期疗效。 [关键词] 药物洗脱支架；左主干；主要心脏事件 [中图分类号] R654 [文献标识码]A [文章编号]1673-7210（2008）06（a）-065-02 Clinical results of drug-eluting stent implantation in unprotected left main LIU Li,LI Zhan-quan,YUAN Long,GUAN Ru-ming (Department of Cardiology, People’s Hospital of Liaoning Province,Shenyang 110016,China) [Abstract] Objective:To evaluate the safety and efficacy of percutaneous coronary intervention with drug eluting stent（DES） in unprotected left main coronary arteries. Methods:From January 2004 to December 2006, 49 patients with unprotected left main stenosis were treated with drug eluting stents and were retrospectively analyzed. 61 drug eluting stents were successfully implanted in 49 unprotected left main diseases. Directing stenting was performed in 10 patients(20.4%), pre-dilation in 39 patients （79.6%）, bifurcation lesion with two stent-technique in 12 patients (24.5%).Results: There were 2 deaths during hospitalization. 44 patients（89.8%）had been clinically followed up in（14±6）months duration.Angiographic follow-up had been performed in 16（32.7%）patients.There were 3 deaths during follow-up,one died of stroke and 2 for suddend death.The major cardiac event rate during follow-up was 6.1%（3/49）. Conclusion:Drug eluting stent is safe when selectively used in unprotected LMCA disease and can achieve optimal acute and long-term clinical results. [Key words] Drug eluting stent;Left main;Major cardiac event 无保护左主干（LMCA）病变长期以来被认为是冠状动脉旁路移植术（CABG）的适应证[1]。近年来冠状动脉金属裸支架置入术越来越多地应用于无保护LMCA病变的治疗，尽管有较理想的手术即刻成功率，但再狭窄仍然是一个重要问题，特别是在长病变、分叉病变病人中尤为突出[2]。药物洗脱支架（DES）应用以来，