Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan; Interventional Cardiology Unit, EMO-GVM, Centro Cuore Columbus, Milan, Italy.
Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan.
Cardiovasc Revasc Med. 2022 Jul;40:57-61. doi: 10.1016/j.carrev.2021.11.009. Epub 2021 Nov 7.
There are no available data about clinical outcomes of simple stenting for ostial left circumflex (LCX) lesions using current generation drug-eluting stents (cDES).
We assessed clinical outcomes after simple stenting using cDES for ostial LCX lesions.
We identified 81 consecutive patients who underwent PCI using cDES for ostial LCX lesions at New Tokyo Hospital, Matsudo, Japan between January 2010 and December 2016. An ostial LCX lesion was defined as a lesion with more than 75% stenosis by visual assessment and within 3 mm of the left main (LM) stem. The primary endpoint was target lesion failure (TLF). TLF was defined as a composite of cardiac death, target lesion revascularization (TLR) and myocardial infarction (MI). Additionally, we also assessed the revascularization for LM to left anterior descending artery (LAD) after ostial LCX stenting.
The TLF rate at 3 years after PCI was 24.5%. Furthermore, the rate of TLR and revascularization for LM-LAD after ostial LCX stenting were significantly higher in patients who were previously undergone stent implantation in ostial segment of LAD.
Clinical outcomes after cDES implantation for ostial LCX lesion could be acceptable. However, it could have better to be avoided in patients who previously received stent implantation in ostial segment of LAD.
目前尚无关于使用新一代药物洗脱支架（cDES）对左回旋支（LCX）开口病变进行单纯支架置入术的临床结果数据。
我们评估了使用 cDES 对 LCX 开口病变进行单纯支架置入术的临床结果。
我们在日本松户市新东京医院确定了 81 例连续患者，这些患者在 2010 年 1 月至 2016 年 12 月期间接受了 cDES 治疗 LCX 开口病变的 PCI。LCX 开口病变定义为通过视觉评估存在超过 75%狭窄的病变，并且病变距离左主干（LM）起始段 3mm 以内。主要终点是靶病变失败（TLF）。TLF 定义为心脏死亡、靶病变血运重建（TLR）和心肌梗死（MI）的复合终点。此外，我们还评估了 LCX 开口支架置入术后对 LM 到前降支（LAD）的再血管化情况。
PCI 后 3 年 TLF 发生率为 24.5%。此外，在先前曾接受 LAD 开口段支架植入术的患者中，LCX 开口支架置入术后 TLR 和 LM-LAD 再血管化的发生率显著升高。
LCX 开口病变使用 cDES 植入的临床结果可以接受。然而，对于先前接受过 LAD 开口段支架植入术的患者，最好避免使用。
