|
|
Efficacy of non-left main bifurcation lesions of coronary artery treated by T-stenting with small protrusion |
TU Jie-hong LI Shun-hui▲ YAN You-liang CHEN Hui TONG Yi-fan LI Jun-hua |
The First Department of Cardiology,the Third Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang 330008,China |
|
|
Abstract Objective To investigate the clinical effect of T-stenting with small protrusion(TAP)technique for non-left main bifurcation lesions of coronary artery,and to compare it with the DK-Crush technique.Methods Eighty patients with non-left main bifurcation lesions of coronary artery admitted to the first department of cardiology,the third affiliated hospital of Nanchang university from July 2014 to March 2017 were enrolled.They were equally divided into TAP group and DK-Crush group in random.The success rate of immediate percutaneous coronary intervention (PCI),the condition of bifurcation,the use of instruments(including number of stents and balloons),X-ray exposure time,contrast agent usage,incidence of stent thrombosis during hospitalization,and incidence of major adverse cardiac events(MACE,including sudden cardiac death,myocardial infarction,stent thrombosis,target vessel revascularization)after 12 months of follow-up were compared in the two groups.Results There was no significant difference in the success rate of immediate PCI between the two groups (P>0.05).In the TAP group,the number of balloons used and angiographic doses were both less compared with those in the DK-Crush group with statistical significance(P<0.05).The X-ray exposure time of the TAP group was shorter than that of the DK-Crush group with a significant difference(P<0.05).No significant difference was displayed in the incidence of MACE after 12 months of follow-up(P>0.05).There was no significant difference in the incidence of stent thrombosis during hospitalization and the incidence of intramural restenosis within 6 to 12 months between the two groups(P>0.05).Conclusion The short-term and long-term clinical efficacy of TAP in the treatment of non-left main bifurcation lesions of coronary artery is comparable to that of DKCrush,but it significantly shortens the exposure time,and reduces the amount of contrast agent,the use of surgical instruments,and medical expenses.
|
|
|
|
|
[2] |
刘海伟,王效增,荆全民,等.改良mini-Crush支架术治疗冠状动脉分叉病变的疗效观察[J].中国介入心脏病学杂志,2015,23(8):428-432.
|
[3] |
戴闽,罗彩东,宋攀,等.TAP技术与改良mini-Crush技术治疗冠状动脉分叉病变临床效果的对比研究[J].实用心脑肺血管病杂志,2016,24(9):63-66.
|
[1] |
Hahn JY,Chun WJ,Kim JH,et al.Predictors and outcomes of side branch occlusion after main vessel stenting in coronary bifurcation lesions:results from the COBIS Ⅱ Registry(COronary BIfurcation Stenting)[J].J Am Coll Cardiol,2013,(62):1654-1659.
|
[4] |
Lassen JF,Holm NR,Stankovic G,et al.Percutaneous coronary intervention for coronary bifurcation disease:consensus from the first 10 years of the European Bifurcation Club meetings[J].Euro Intervention,2014,(10):545-560.
|
[5] |
蒋芳勇,韦金儒,黎荣山.TAP技术与单支架技术治疗冠状动脉分叉病变的疗效对比[J].介入放射学杂志,2013,22(4):279-282.
|
[6] |
王芳,左长鹏,纵静,等.不同性别老年冠状动脉真性分叉病变患者的临床特征及介入治疗预后分析[J].中国介入心脏病学杂志,2017,25(3):153-157.
|
[7] |
Alegría-Barrero E,Foin N,Chan PH,et al.Optical coherence tomography for guidance of distal cell recrossing in bifurcation stenting:choosing the right cell matters[J].Euro Intervention,2012,(8):205-213.
|
[8] |
张磊,夏勇,马延峰,等.真分叉病变术中并发冠状动脉穿孔一例[J].中国介入心脏病学杂志,2015,23(2):114-115.
|
[9] |
Fabris E,Kennedy MW,Di Mario C,et al.Guide extension,unmissable tool in the armamentarium of modern interventional cardiology.A comprehensive review[J].Int J Cardiol,2016,(222):141-147.
|
[10] |
金昭,武宗寅.比较简单与复杂支架技术治疗冠状动脉多支血管病变的临床疗效[J].中国循环杂志,2015,30(3):301-303.
|
[11] |
王冠男,张健,石宇杰,等.直径分型法及其指导下的冠状动脉分叉病变介入治疗临床观察[J].中国循证心血管医学杂志,2016,8(4):403-407.
|
[12] |
郑绪伟,柳景华.冠状动脉分叉病变血液流变学的研究进展[J].中国介入心脏病学杂志,2014,22(9):589-591.
|
[13] |
熊青峰,张雪莲,陈险峰,等.冠状动脉左主干病变双源CTA影像学特征及临床应用[J].中国介入影像与治疗学,2016,13(5):297-301.
|
[14] |
肖寒.边支导丝“逃逸”技术在分叉病变必要时支架术中的应用研究[D].重庆:第三军医大学,2017.
|
[15] |
李龙虎,金哲,王美兰,等.冠状动脉分叉病变的主动球囊保护技术:球囊支架对吻术[J].中国介入心脏病学杂志,2014,22(3):181-184.
|
[16] |
胡晶,荆全民.冠状动脉分叉病变单支架治疗分支是否需要对吻后扩张[J].心血管病学进展,2014,35(4):458-460.
|
[17] |
李明哲,吴强,赵爱民,等.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[J].岭南心血管病杂志,2014,20(5):567-570,594.
|
[18] |
洪浪,王洪,李林锋,等.前送球囊DK-Crush技术治疗真性冠状动脉分叉病变:与经典DK-Crush技术对比[J].中国医学前沿杂志(电子版),2013,5(9):69-73.
|
[19] |
龚辉,黄定,张向阳.小球囊保护冠脉分叉病变分支的临床分析[J].循证医学,2017,17(3):159-162,170.
|
[20] |
王前程.闭塞时间与冠状动脉慢性完全闭塞(CTO)病变正向导丝技术介入治疗成功的相关性分析[D].大连:大连医科大学,2016.
|
|
|
|