Objective To compare the application effect on PCI in patients with true coronary bifurcation lesions between pre-dilated balloon technique and simple guide wire protection technique.Methods From 2007 to 2016,a total of 166 true coronary bifurcation lesion patients undergoing PCI were selected in the Department of Cardiovascular Medicine,the People's Hospital of Yuzhou District,Yulin,and they were divided into A group(n=87)and B group(n=79)according to surgical procedures. Patients in the two groups received main vessel stent implantation and simple processing strategy to protect the branch lesions,meanwhile patients in A group received pre-dilated balloon technique,while patients in B group received simple guide wire protection technique. Incidence of postoperative complications and operation related indicators were compared between the two groups,incidence of MACE,vascular stenosis status and re-hospitalization rate were recorded during the 1-year follow-up.Results No one in the two groups occurred entrapment or breakage of balloon/guide wire,serious vascular complications,death or acute myocardial infarction. No statistically significant differences of incidence of clinical symptoms or myocardial damage was found between the two groups(P>0.05),while incidence of branch occlusion/ dissection in A group was statistically significantly lower than that in B group(P<0.05). No statistically significant differences of success rate of PCI,proportion of patients received branch stent implantation,duration of operation,X-ray exposure duration or dosage of contrast media was found between the two groups(P>0.05);proportion of patients received expansion after end to end anastomosis and incidence of branch no reflow phenomenon during operation in A group were statistically significantly lower than those in B group(P<0.05). Incidence of MACE in A group and branch opening stenosis rate were statistically significantly lower than those in B group during treatment(P<0.05),while no statistically significant differences of maximum stenosis rate or restenosis rate of main vessel,or re-hospitalization rate was found between the two groups(P>0.05).Conclusion Compared with simple guide wire protection technique,pre-dilated balloon technique has better protective effect on branch lesions in postoperative true coronary bifurcation patients treated by PCI,can more effectively reduce the risk of branch occlusion/ dissection,MACE and branch opening stenosis.%目的 比较预扩张球囊技术与单纯导丝保护技术在冠状动脉真性分叉病变患者经皮冠状动脉介入治疗(PCI)中的应用效果.方法 选取2007—2016年在玉林市玉州区人民医院心血管内科行PCI的冠状动脉真性分叉病变患者166例,按照手术方式不同分为球囊组87例和导丝组79例.两组患者均在主支血管置入支架,并采用简单处理策略保护分支血管病变,球囊组患者PCI术中采用预扩张球囊技术,而导丝组患者PCI术中采用单纯导丝保护技术.比较两组患者术后并发症发生情况和手术情况;随访1年,记录两组患者主要不良心血管事件(MACE)发生情况、病变血管狭窄情况及再次住院率.结果 两组患者分支血管球囊及导丝未发生截留或断裂,术后未出现严重血管并发症、死亡和急性心肌梗死.两组患者临床症状、心肌损伤发生率比较,差异无统计学意义(P>0.05);球囊组患者分支血管闭塞或夹层发生率低于导丝组(P<0.05).两组患者PCI成功率、分支血管置入支架者所占比例、手术时间、X线暴露时间及造影剂用量比较,差异无统计学意义(P>0.05);球囊组患者行对吻后扩张者所占比例和术中分支血管无复流发生率低于导丝组(P<0.05).球囊组患者随访期间MACE发生率、分支血管开口狭窄率低于导丝组(P<0.05),而两组患者主支血管最大狭窄率、主支血管再狭窄率及再次住院率比较,差异无统计学意义(P>0.05).结论 与单纯导丝保护技术相比,预扩张球囊技术对冠状动脉真性分叉病变患者PCI后分支血管病变的保护作用更好,能更有效地降低术后分支血管闭塞或夹层发生率、MACE发生率及分支血管开口狭窄率.
展开▼
