使用西罗莫司洗脱支架治疗非左主干分叉病变：交叉单支架置入术与 crush 支架置入术的慢性结局比较。

Treatment of non-left main bifurcation lesions using the sirolimus-eluting stent: A comparison of chronic outcomes of cross-over single stenting and crush stenting.

机构信息

Division of Interventional Cardiology, Toho University Omori Medical Center, 6-11-1, Omori-nishi, Ota-ku, Tokyo, Japan.

出版信息

J Cardiol. 2010 Mar;55(2):180-8. doi: 10.1016/j.jjcc.2009.10.005. Epub 2009 Dec 24.

DOI:10.1016/j.jjcc.2009.10.005

PMID:20206070

Abstract

BACKGROUND

It is said that the chronic outcomes of the two-stent technique for bifurcation lesions are inferior to that of cross-over single stenting. However, there are many cases where true bifurcations are difficult to treat by single stenting and, in particular, strategies for bifurcation lesions that are not left main trunk (LMT) bifurcations are still not clear.

OBJECTIVE

This study aims to compare the usefulness of crush stenting with that of cross-over single stenting using the sirolimus-eluting stent (SES) on bifurcation lesions with the exclusion of LMT bifurcations.

METHODS

Subjects were 92 consecutive patients (100 lesions) who underwent cross-over single stenting or crush stenting using SES for bifurcation lesions with the exclusion of LMT bifurcations. The patients were divided into 33 patients with 34 lesions, in whom the stent was implanted in the main vessel alone with the kissing balloon technique performed for the main vessel and side branch (Single-stenting group; S group), and 59 patients with 66 lesions, in whom the stent was implanted through crush stenting (Crush-stenting group; C group). The two groups were compared for target lesion revascularization (TLR) and major adverse cardiac events (MACE).

RESULTS

There were no differences for TLR, with this conducted in the main vessel in 5.9% of S group and 4.5% of C group. There was no difference between the groups in MACE with 9.1% in S group and 8.5% in C group. No significant difference was seen in MACE-free survival rate in the chronic phase with 93.9% for S group and 94.9% for C group (P=NS).

CONCLUSION

No differences in chronic clinical outcomes were revealed in a comparison between cross-over single stenting and crush stenting. Good clinical outcomes were achieved by both cross-over single stenting and crush stenting in the treatment of non-left main bifurcation lesions.

摘要

背景

据说，分叉病变的双支架技术的慢性结果不如交叉单支架技术。然而，有许多真正的分叉病变很难通过单支架治疗，特别是对于非左主干分叉病变的分叉病变策略仍然不清楚。

目的

本研究旨在比较使用西罗莫司洗脱支架（SES）治疗除左主干分叉病变以外的分叉病变时，交叉单支架与对吻球囊技术的应用。

方法

92 例连续患者（100 处病变）接受交叉单支架或 SES 对吻球囊技术治疗除左主干分叉病变以外的分叉病变。患者分为 33 例 34 处病变，支架单独植入主血管，主血管和侧支采用对吻球囊技术（单支架组；S 组）；59 例 66 处病变，支架通过 crush 技术植入（Crush-stenting 组；C 组）。比较两组的靶病变血运重建（TLR）和主要不良心脏事件（MACE）。