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真性分叉支架置入术的即刻、短期、中期和长期临床结局

Immediate, Short-Term, Intermediate, and Long-Term Clinical Outcomes of True Bifurcation Stenting.

作者信息

Qadir Mamoon, Ali Anwar, Khalid Fahad, Umar Khan Bakht, Saifullah Khan Iqbal, Akbar Amna, Jadoon Sarosh Khan, Tasneem Sabahat

机构信息

Interventional Cardiology, Fellowship of the Royal College of Physicians (FRCP, UK) Kulsum International Hospital, Polyclinic Hospital Islamabad, Islamabad, PAK.

CT Angiography, Kulsum International Hospital, Islamabad, PAK.

出版信息

Cureus. 2024 Aug 19;16(8):e67251. doi: 10.7759/cureus.67251. eCollection 2024 Aug.

Abstract

INTRODUCTION

Coronary artery bifurcation lesion is an epicardial stenosis that, when compared to non-bifurcation lesions, poses a greater risk of adverse events and can compromise prognosis. This study aims to investigate the clinical efficacy of different stenting techniques, particularly in terms of their immediate, short-term, intermediate, and long-term outcomes in patients with true bifurcation lesions.

METHODOLOGY

This retrospective observational cohort study was conducted in a tertiary cardiac hospital in Islamabad, from February 1, 2015, to February 28, 2021. A total of 172 patients who met the inclusion criteria and underwent percutaneous coronary intervention were selected using a consecutive sampling technique. Follow-up was maintained for three years to assess procedural outcomes.

RESULTS

Of the 172 participants, the majority were males (69%) and only 4% were above 75 years of age. A significant relation between major adverse cardiac events (MACEs) with acute coronary syndrome (ACS) and previous percutaneous coronary intervention (PCI) (p < 0.000) was observed. Procedural success was good in all patients using the drug-eluting stent. The MAC rate was 6.9% and the final kissing balloon inflation, stenting technique, and bifurcation involvement were significantly associated with MACE occurrence (p < 0.01), and mortality was reported in two patients (1.16%). MACEs were associated with mortality; previous PCI and hypertension increased the risk of mortality.

CONCLUSION

The two-stent strategy can be used with good long-term outcomes and low complication rates.

摘要

引言

冠状动脉分叉病变是一种心外膜狭窄,与非分叉病变相比,其不良事件风险更高,可能影响预后。本研究旨在探讨不同支架置入技术的临床疗效,特别是在真性分叉病变患者中的即刻、短期、中期和长期结果。

方法

本回顾性观察队列研究于2015年2月1日至2021年2月28日在伊斯兰堡的一家三级心脏医院进行。采用连续抽样技术选取了172例符合纳入标准并接受经皮冠状动脉介入治疗的患者。随访三年以评估手术结果。

结果

172名参与者中,大多数为男性(69%),75岁以上者仅占4%。观察到主要不良心脏事件(MACE)与急性冠状动脉综合征(ACS)和既往经皮冠状动脉介入治疗(PCI)之间存在显著相关性(p < 0.000)。所有使用药物洗脱支架的患者手术成功率均良好。MAC发生率为6.9%,最终球囊对吻扩张、支架置入技术和分叉受累与MACE发生显著相关(p < 0.01),有两名患者(1.16%)报告死亡。MACE与死亡率相关;既往PCI和高血压增加了死亡风险。

结论

双支架策略可用于获得良好的长期结果和较低的并发症发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a18d/11411170/4b087e165187/cureus-0016-00000067251-i01.jpg

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