Institut Hospitalier Jacques Cartier, Massy, France.
EuroIntervention. 2011 Oct 30;7(6):689-96. doi: 10.4244/EIJV7I6A111.
We sought to assess the efficacy and safety of everolimus-eluting stents for unprotected left main disease.
A total of 173 consecutive patients with de novo significant unprotected left main stenosis received an everolimus-eluting stent in four French centres. Among them, 140 (81 %) had involvement of the distal portion of left main, and 129/140 (92%) were treated with provisional side branch T-stenting, with a side branch stenting rate of 20%. Angiographic success was achieved in all cases. At 12 months, the cumulative rate of major adverse cardiac or cerebrovascular events (MACCE) was 26/173 (15%) including death from any cause (N=5, 2.9%), stroke (N=4, 2.3%), Q-wave myocardial infarction (MI) (N=2, 1.2%), non-Q-wave MI (N=6, 3.5%) and any repeat revascularisation (N=16, 9.3%). At one year, the rate of target-lesion revascularisation (TLR) was 5/173 (2.9%), target-vessel revascularisation was 12/173 (7 %) and the rate of definite or probable left main stent thrombosis 1/173 (0.6 %).
Unprotected left main stenting using everolimus-eluting stents and a strategy of provisional side branch T-stenting for distal lesions, is safe and effective in the midterm, with a relatively low rate of events and reintervention at one year.
我们旨在评估依维莫司洗脱支架治疗无保护左主干病变的疗效和安全性。
共有 173 例初发严重无保护左主干狭窄的患者在四家法国中心接受依维莫司洗脱支架治疗。其中，140 例（81%）患者存在左主干远端病变，140 例中的 129 例（92%）采用了临时分支 T 型支架术治疗，分支支架置入率为 20%。所有病例均达到了血管造影成功。12 个月时，主要不良心脑血管事件（MACCE）的累积发生率为 26/173（15%），包括任何原因死亡（N=5，2.9%）、卒中（N=4，2.3%）、Q 波心肌梗死（MI）（N=2，1.2%）、非 Q 波 MI（N=6，3.5%）和任何再次血运重建（N=16，9.3%）。1 年时，靶病变血运重建率（TLR）为 5/173（2.9%），靶血管血运重建率为 12/173（7%），明确或可能的左主干支架内血栓形成率为 1/173（0.6%）。
采用依维莫司洗脱支架和临时分支 T 型支架术治疗远端病变的无保护左主干支架置入术，在中期是安全有效的，1 年时的事件和再介入率相对较低。
