Wong P, Wong V, Tse K K, Chan W, Ko P, Wong C M, Leung A W, Fong P C, Cheng C H, Tai Y T, Leung W H, Liu M L
Cardiac Catheterization Laboratory, Adventist Hospital, Hong Kong.
Catheter Cardiovasc Interv. 1999 Feb;46(2):153-9. doi: 10.1002/(SICI)1522-726X(199902)46:2<153::AID-CCD8>3.0.CO;2-7.
The standard treatment of left main coronary artery (LMCA) disease has been bypass surgery (CABG). Recent reports suggested that stenting of LMCA disease might be feasible. From January 1995 to April 1998, we carried out a prospective study of elective stenting of unprotected LMCA disease to evaluate its immediate and long-term results. Of 61 consecutive patients with unprotected LMCA disease, 6 were excluded. Acute procedural success was 100% for the remaining 55 patients, without any complications such as stent thrombosis, myocardial infarction, CABG, or death. During a mean follow-up of 16.1+/-9.6 months, 11 patients (20%) had symptomatic recurrence, between 2 to 6 months after their procedure. Seven patients underwent CABG, two had repeat intervention, one continued with medical therapy, and one died before planned angiography. There was no late sudden death. Forty-four patients (80%) remained asymptomatic. We conclude that elective stenting may be a safe alternative to CABG in unprotected LMCA disease.
左冠状动脉主干（LMCA）疾病的标准治疗方法一直是冠状动脉搭桥术（CABG）。最近的报告表明，对LMCA疾病进行支架置入术可能是可行的。从1995年1月至1998年4月，我们对无保护的LMCA疾病的择期支架置入术进行了一项前瞻性研究，以评估其近期和长期结果。在连续61例无保护的LMCA疾病患者中，6例被排除。其余55例患者的急性手术成功率为100%，未出现任何并发症，如支架血栓形成、心肌梗死、CABG或死亡。在平均16.1±9.6个月的随访期间，11例患者（20%）在术后2至6个月出现症状复发。7例患者接受了CABG，2例进行了再次干预，1例继续接受药物治疗，1例在计划的血管造影术前死亡。无晚期猝死。44例患者（80%）仍无症状。我们得出结论，在无保护的LMCA疾病中，择期支架置入术可能是CABG的一种安全替代方法。
