Worthley Stephen, Hendriks Randall, Worthley Matthew, Whelan Alan, Walters Darren L, Whitbourn Robert, Meredith Ian
Cardiovascular Investigation Unit, Royal Adelaide Hospital and University of Adelaide, Adelaide, Australia.
Cardiology Research Centre, Fremantle Hospital, Fremantle, Australia.
Cardiovasc Revasc Med. 2015 Oct-Nov;16(7):413-7. doi: 10.1016/j.carrev.2015.07.009. Epub 2015 Aug 10.
Several studies investigated the combination of bare metal stents in the main branch and drug-eluting balloons in the side branch in bifurcation lesions, but data on the combination of drug-eluting stents and drug-eluting balloons are scarce. We aim to assess the feasibility of provisional stenting with an everolimus-eluting stent in the main branch and a paclitaxel-eluting balloon in the side branch.
In this prospective, multi-center study conducted in 5 Australian sites, 35 patients with bifurcation lesions were enrolled. Angiographic and intravascular ultrasound assessments were conducted at 9 months; clinical follow-up was conducted until 12 months.
The primary endpoint, late lumen loss in the side branch measured by quantitative coronary angiography, was 0.10±0.43mm. No binary restenosis was observed. One patient died; 3 myocardial infarctions (one suspected and two in non-target vessels) and one target lesion revascularization occurred. No probable or definite stent thrombosis was observed.
The combination of an everolimus-eluting stent in the main branch and a paclitaxel-eluting balloon in the side branch appears to be a safe, effective and novel treatment option for bifurcation lesions.
多项研究探讨了在分叉病变中主支使用裸金属支架与分支使用药物洗脱球囊的联合应用,但关于药物洗脱支架与药物洗脱球囊联合应用的数据较少。我们旨在评估在主支使用依维莫司洗脱支架并在分支使用紫杉醇洗脱球囊进行临时支架置入的可行性。
在澳大利亚5个中心进行的这项前瞻性多中心研究中,纳入了35例分叉病变患者。在9个月时进行血管造影和血管内超声评估;临床随访至12个月。
主要终点,即通过定量冠状动脉造影测量的分支晚期管腔丢失为0.10±0.43mm。未观察到二元再狭窄。1例患者死亡;发生了3次心肌梗死(1例疑似,2例发生在非靶血管)和1次靶病变血运重建。未观察到可能或明确的支架血栓形成。
在主支使用依维莫司洗脱支架并在分支使用紫杉醇洗脱球囊的联合应用似乎是一种用于分叉病变的安全、有效且新颖的治疗选择。