Division of Cardiology, Department of Medicine, Beth Israel Medical Center, New York, NY 10003, USA.
Angiology. 2010 Oct;61(7):633-7. doi: 10.1177/0003319710369098. Epub 2010 Jun 7.
There are little long-term clinical data regarding the safety and efficacy of using 2 drug-eluting stents (DESs) to treat coronary bifurcation lesions. We obtained clinical follow-up for 124 consecutive patients who underwent bifurcation stenting with 2 DESs. Major adverse cardiac events (MACEs) were defined as cardiac death, acute myocardial infarction (AMI), and target vessel revascularization (TVR). Sixty-four (52%) patients underwent ''crush,'' 42 (34%) patients underwent T stent, and 18 (14%) patients underwent kissing stent. Major adverse cardiac events were observed in 19 patients (17%) at 1 year: 6 (5%) AMI, 13 (12%) TVR, and no deaths, and 29 patients (26 %) at a mean follow-up of 22 months: 7 (6%) AMI, 21 (19%) TVR, and 1 (1%) death. No statistically significant risk factors for long-term MACEs were identified. It appears that treating bifurcation lesions with 2 DESs when necessary can be performed with an acceptable MACE rate.
关于使用 2 个药物洗脱支架（DES）治疗冠状动脉分叉病变的安全性和有效性，目前仅有少量长期临床数据。我们对 124 例连续接受 2 个 DES 分叉支架置入术的患者进行了临床随访。主要不良心脏事件（MACE）定义为心脏死亡、急性心肌梗死（AMI）和靶血管血运重建（TVR）。64 例（52%）患者行“Crush”术，42 例（34%）患者行 T 支架术，18 例（14%）患者行对吻支架术。1 年内有 19 例（17%）患者发生主要不良心脏事件：6 例（5%）心肌梗死，13 例（12%）TVR，无死亡；22 个月的平均随访中，有 29 例（26%）患者发生主要不良心脏事件：7 例（6%）心肌梗死，21 例（19%）TVR，1 例（1%）死亡。未发现长期 MACE 的统计学显著危险因素。对于需要的分叉病变，使用 2 个 DES 治疗似乎可以获得可接受的 MACE 率。
