Hong M K, Mintz G S, Hong M K, Pichard A D, Satler L F, Kent K M, Popma J J, Leon M B
Intravascular Ultrasound Imaging and Cardiac Catheterization Laboratories, Washington Hospital Center, Washington, DC, USA.
Am J Cardiol. 1999 Jan 15;83(2):175-9. doi: 10.1016/s0002-9149(98)00820-0.
We evaluated the predictors of late clinical outcomes after stenting of protected left main coronary artery (LMCA) stenoses. Intravascular ultrasound (IVUS) guided stenting of protected LMCA stenoses was performed in 87 consecutive patients between January 1994 and December 1996. Results were evaluated using conventional (clinical, angiographic, and IVUS) methodology. Late (12 month) clinical follow-up information was obtained in all patients. Initial procedural success was achieved in 86 patients (99%). There was 1 in-hospital death (in the 1 patient with a procedural failure). There were no other in-hospital complications, including Q-wave myocardial infarction, emergency bypass surgery, or repeat coronary angioplasty. The overall target lesion revascularization (TLR) rate was 13%. Using multivariate logistic regression analysis, the only independent predictor of TLR was the postintervention lumen area by IVUS. A final lumen area > or =7.0 mm2 was obtained in 74 patients (86%); the TLR rate for these patients was 7%. This was compared with patients with a final lumen area <7.0 mm2 in whom the TLR rate was 50% (p = 0.0011). Stenting of protected LMCA stenoses is safe and effective with acceptable long-term clinical outcomes. The most important factor determining long-term success was the postintervention lumen area by IVUS.
我们评估了受保护的左主干冠状动脉（LMCA）狭窄支架置入术后晚期临床结局的预测因素。1994年1月至1996年12月期间，对87例连续患者进行了血管内超声（IVUS）引导下的受保护LMCA狭窄支架置入术。使用传统方法（临床、血管造影和IVUS）评估结果。所有患者均获得了晚期（12个月）临床随访信息。86例患者（99%）取得了初始手术成功。有1例住院死亡（该例患者手术失败）。没有其他住院并发症，包括Q波心肌梗死、急诊搭桥手术或重复冠状动脉成形术。总体靶病变血管重建（TLR）率为13%。使用多因素逻辑回归分析，TLR的唯一独立预测因素是IVUS测定的干预后管腔面积。74例患者（86%）获得最终管腔面积≥7.0 mm²；这些患者的TLR率为7%。与之相比，最终管腔面积<7.0 mm²的患者TLR率为50%（p = 0.0011）。受保护的LMCA狭窄支架置入术安全有效，长期临床结局可接受。决定长期成功的最重要因素是IVUS测定的干预后管腔面积。
