Timurkaynak Timur, Ciftci Haci, Ozdemir Murat, Cengel Atiye, Tavil Yusuf, Kaya Mehmet, Erdem Guliz, Cemri Mustafa, Dortlemez Ovsev, Dortlemez Halis
Gazi University Medical School, Department of Cardiology, Ankara, Turkey.
J Invasive Cardiol. 2002 Sep;14(9):497-501.
Direct stenting (DS) is a novel approach in percutaneous treatment of coronary artery lesions. Several studies confirmed the safety and feasibility of the procedure with success rates greater than 90%. However, the data regarding the incidence of sidebranch occlusion (SBO) after DS are scarce. The purpose of this study was to evaluate SBO (> 1 mm) after DS and compare it to conventional stenting (CS) with balloon predilation. The study population consisted of 151 patients (88 underwent DS, 63 underwent CS) with 185 sidebranches jailed by the stent (110 in DS group, 75 in CS group). SBO was observed in 20 out of 110 patients in the DS group (18.2%) and 18 out of 75 patients in the CS group (24%). Although the incidence of SBO was higher in the CS group compared to the DS group (24% vs. 18.2%, respectively), these values did not reach statistical significance (p > 0.05). Most of the SBOs were observed in cases with type D sidebranch morphology (p < 0.001) and in cases with sidebranch ostial diameter stenosis 50% (p = 0.019). None of the other clinical and angiographic variables predicted the SBO. To the best of our knowledge, this is the first report comparing incidence of SBO between two different PCI methods (CS vs DS). Randomized studies with larger patient populations should be conducted to compare this approach with conventional stenting.
直接支架置入术（DS）是冠状动脉病变经皮治疗中的一种新方法。多项研究证实了该手术的安全性和可行性，成功率超过90%。然而，关于DS术后分支闭塞（SBO）发生率的数据却很少。本研究的目的是评估DS术后的SBO（>1mm）情况，并将其与球囊预扩张的传统支架置入术（CS）进行比较。研究人群包括151例患者（88例行DS，63例行CS），共有185个分支被支架覆盖（DS组110个，CS组75个）。DS组110例患者中有20例（18.2%）观察到SBO，CS组75例患者中有18例（24%）观察到SBO。虽然CS组的SBO发生率高于DS组（分别为24%和18.2%），但这些数值未达到统计学显著性（p>0.05）。大多数SBO发生在D型分支形态的病例中（p<0.001）以及分支开口直径狭窄≥50%的病例中（p=0.019）。其他临床和血管造影变量均未预测到SBO。据我们所知，这是第一份比较两种不同PCI方法（CS与DS）之间SBO发生率的报告。应进行更大患者群体的随机研究，以将这种方法与传统支架置入术进行比较。
