Rawlins John, Din Jehangir, Talwar Suneel, O'Kane Peter
Dorset Heart Centre, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, UK.
Interv Cardiol. 2015 May;10(2):85-89. doi: 10.15420/icr.2015.10.2.85.
The successful treatment of coronary bifurcation lesions remains one of the challenges of interventional cardiology. The current consensus of the European Bifurcation Club based on published data advocates a provisional strategy, treating the main vessel (MV) with a single stent covering the side branch (SB), with bailout SB stenting as required. The success of this approach may be limited by failure to attain SB access after MV stenting but is preferred in most situations over routine SB plus MV stent techniques, which are associated with a significant increase in the rate of major adverse cardiac events. The AXXESS self-expanding biolimus-eluting stent has been developed as a solution to these challenges within the coronary circulation and maintains provisional MV stent approach but with added assurance of maintained SB access. It has a unique conical structure that is positioned spanning the carina, with scaffold extending into the carina of both the MV and SB. The purpose of this article is to describe the indication, implantation technique and outcome data supporting the use of the AXXESS stent in the treatment of coronary bifurcation lesions.
冠状动脉分叉病变的成功治疗仍然是介入心脏病学面临的挑战之一。欧洲分叉俱乐部基于已发表数据的当前共识主张采用临时策略，即用单个覆盖分支血管（SB）的支架治疗主血管（MV），并根据需要进行补救性SB支架置入。这种方法的成功可能会受到MV支架置入后无法实现SB入路的限制，但在大多数情况下，它比常规的SB加MV支架技术更可取，因为后者会显著增加主要不良心脏事件的发生率。AXXESS自膨胀生物雷帕霉素洗脱支架已被开发出来，作为解决冠状动脉循环中这些挑战的一种方案，它维持临时MV支架置入方法，但增加了维持SB入路的保障。它具有独特的锥形结构，跨越嵴部定位，支架延伸到MV和SB的嵴部。本文的目的是描述支持使用AXXESS支架治疗冠状动脉分叉病变的适应症、植入技术和结果数据。
