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目的通过临床和冠脉造影评价“一站式”复合技术旁路的中期通畅率及临床疗效。方法 2010.10～2011.12共42例接受“一站式”复合技术治疗患者随访观察,所有患者均免于主要心脏或脑血管不良事件(Major adverse cardiac or cerebrovascular events,MACCE)发生的生存率,同时行冠脉造影确认患者左内乳动脉(left internal mammaryar tery LIMA)旁路及非左前降支(left anterior descending artery LAD)靶血管药物支架通畅率。男37例,女5例,年龄64.3±9.6岁,平均随访时间18±8.9个月。结果 42例患者均无MACCE。患者心功能Ⅰ级19例,Ⅱ级23例。冠脉造影结果显示:LIMA旁路42支,狭窄1支,闭塞1支,通畅率95.2%(40/42)。药物支架植入靶血管52支,再狭窄5支。LIMA旁路闭塞后LAD再次支架植入1支,原支架再狭窄再次植入支架病变冠脉2支,再次支架植入治疗冠脉新发病变3支。非LAD病变冠脉通畅率82.7%(43/52)。结论 “一站式”复合技术治疗冠状动脉多支病变患者术后18个月的LIMA-LAD旁路和非LAD靶血管的药物支架具有较高的通畅率,提示一站式复合技术治疗冠状动脉多支病变术后1年通畅率及临床疗效优于文献报道的单纯冠状动脉旁路移植术(Coronary artery bypass graftingCABG)或经皮冠状动脉介入治疗(Percutaneous coronary intervention PCI)的通畅率,其长期效果需要进一步随访。
Objective To evaluate the mid-term patency rate and clinical efficacy of clinical and coronary angiography bypassing “one-stop” composite technique. METHODS: From January 2010 to December 2011, 42 patients underwent “one-stop” composite therapy were followed up. All patients were free from the survival rate of major adverse cardiac or cerebrovascular events (MACCE) Coronary angiography confirmed the patency rate of the target vessel of the left internal mammaryarmary LIMA bypass and non-left anterior descending artery LAD. There were 37 males and 5 females, aged 64.3 ± 9.6 years, with an average follow-up of 18 ± 8.9 months. Results None of the 42 patients had MACCE. Patients with cardiac function grade Ⅰ 19 cases, Ⅱ grade 23 cases. Coronary angiography showed that LIMA bypass 42, stenosis 1, occlusion 1, patency rate 95.2% (40/42). Drug stent implantation target vessel 52, 5 restenosis. LIMA bypass occlusion after LAD stents again implanted a stent restenosis once again implanted scaffold coronary artery 2, again stent implantation treatment of coronary new lesions 3. Non-LAD lesions coronary artery patency rate was 82.7% (43/52). Conclusion The “one-stop” composite technique has a higher patency rate in the LIMA-LAD bypass and non-LAD target vessels at 18 months after operation in patients with coronary artery disease, suggesting a one-stop composite therapy The patency rate and clinical efficacy at 1 year after coronary artery multi-vessel disease were better than those in the reported coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) Long-term results need further follow-up.