Gambhir D S, Sudha R, Singh S, Batra R, Sethi K K, Mohan J C, Nair M, Kaul U A, Arora R
Department of Cardiology, GB Pant Hospital, New Delhi.
Indian Heart J. 1997 Sep-Oct;49(5):493-6.
Between February 1995 to August 1997, 120 patients underwent elective stent implantation for isolated proximal left anterior descending coronary artery stenosis. Their age ranged from 31 to 72 years (mean: 50.8 +/- 10.2) and the majority (89%) were males. All patients had angina, documented myocardial ischemia or both and 70 percent or more luminal diameter stenosis in the proximal left anterior descending before the origin of any branch. Majority (62.5%) of the treated lesions were type A. Successful deployment of the stent at the target site was achieved in all patients without any major in-hospital complications, including myocardial infarction, emergency bypass graft surgery or death. Clinical follow-up, ranging from 6 to 31 months (mean: 18.5 +/- 8.1, median: 20), was available in 87 out of 92 (94.5%) eligible patients who had completed at least six months after the procedure. Freedom from angina, myocardial infarction, target lesion revascularization and death was observed in 90.8, 100, 95.4 and 97.7 percent of patients, respectively. By the Kaplan-Meier estimate, an event-free survival (absence of death, myocardial infarction, recurrence of angina or revascularization) was 95.4 percent at six months, 89.5 percent at 12 and 18 months and 82.7 percent at 24 to 31 months of follow-up. Only 10 (11.5%) patients developed any event and TLR was required in 4.6 percent of patients. In conclusion, elective stenting for isolated proximal left anterior descending stenosis can be achieved safely and successfully in all patients without any adverse in-hospital events. This modality of treatment also provides long-term benefits in terms of reduction in major cardiovascular events and need for subsequent revascularization.
1995年2月至1997年8月期间，120例患者因孤立性左前降支近端冠状动脉狭窄接受了择期支架植入术。他们的年龄在31至72岁之间（平均：50.8±10.2），大多数（89%）为男性。所有患者均有胸痛、记录在案的心肌缺血或两者兼有，且在任何分支起始之前，左前降支近端管腔直径狭窄达70%或更多。大多数（62.5%）治疗病变为A型。所有患者在靶病变部位成功植入支架，未发生任何重大院内并发症，包括心肌梗死、急诊搭桥手术或死亡。92例符合条件的患者中，87例（94.5%）在术后至少六个月完成了6至31个月（平均：18.5±8.1，中位数：20）的临床随访。分别有90.8%、100%、95.4%和97.7%的患者无胸痛、心肌梗死、靶病变血管重建和死亡。根据Kaplan-Meier估计，随访6个月时无事件生存率（无死亡、心肌梗死、心绞痛复发或血管重建）为95.4%，12个月和18个月时为89.5%，24至31个月时为82.7%。仅10例（11.5%）患者发生任何事件，4.6%的患者需要进行靶病变血管重建。总之，孤立性左前降支近端狭窄的择期支架植入术在所有患者中均可安全、成功实施，且无任何不良院内事件。这种治疗方式在减少主要心血管事件和后续血管重建需求方面也具有长期益处。
