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冠状动脉分叉病变生物可吸收血管支架的血管造影及中期结果。

Angiographic and Midterm Outcomes of Bioresorbable Vascular Scaffold for Coronary Bifurcation Lesions.

机构信息

Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.

Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.

出版信息

Am J Cardiol. 2018 Dec 15;122(12):2035-2042. doi: 10.1016/j.amjcard.2018.09.003. Epub 2018 Sep 13.

Abstract

Data on the angiographic and clinical performance of bioresorbable vascular scaffolds (BVS) for bifurcation lesions treatment are still limited. Data were examined of 107 patients with at least 1 coronary bifurcation lesion involving a side branch ≥2mm. Angiographic and clinical outcomes were collected. Optical coherence tomography analysis was performed in a subgroup of patients. Between July 2009 and December 2015, 423 patients underwent PCI with Absorb BVS. A total of 110 lesions were identified as bifurcations, of which 24.5% were classified as true bifurcation lesions. Lesion complexity B2/C was 68.1%. Ninety-five out of 110 lesions were treated by provisional stenting technique while 2 stenting strategy was the final approach in 15 lesions. Procedural success of main branch was 100% whereas side-branch impairment at the end of the procedure was 4.5%. The mean follow-up was 21 months with one-third of the patients followed up for at least 2 years. The overall target lesion failure and scaffold/stent thrombosis rate at 1 year was 7.8% and 3.9%, respectively. In conclusion the results of the present analysis suggest the BVS implanted in bifurcations lesions are associated with procedural safety and angiographic success as well as acceptable target lesion failure rate at 1 year.

摘要

关于生物可吸收血管支架(BVS)治疗分叉病变的血管造影和临床性能的数据仍然有限。本研究共纳入了 107 例至少存在 1 处累及≥2mm 边支的冠状动脉分叉病变患者,收集了他们的血管造影和临床结果。对部分患者进行了光学相干断层扫描分析。2009 年 7 月至 2015 年 12 月期间,共有 423 例患者接受 Absorb BVS 行 PCI 治疗。共发现 110 处分叉病变,其中 24.5%为真性分叉病变,病变复杂程度 B2/C 者占 68.1%。110 处病变中有 95 处采用了预扩张支架技术,15 处病变最终采用了双支架技术。主支血管的手术成功率为 100%,但术后即刻边支受损率为 4.5%。平均随访时间为 21 个月,三分之一的患者随访时间至少为 2 年。1 年时的总体靶病变失败和支架血栓形成率分别为 7.8%和 3.9%。综上所述,本分析结果表明,BVS 治疗分叉病变具有良好的安全性和血管造影成功率,1 年靶病变失败率可接受。

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