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目的斑块和界嵴的移位可能是造成分支血管闭塞的主要原因。为确认界嵴移位与分支闭塞的关系,我们比较了不同界嵴角度的两组分叉病变在分支闭塞发生率方面的差别。方法和结果本研究连续入选1200例分叉病变,均采用单支架或必要时双支架策略。以中位数31°为界,将病变分为高界嵴角度和低界嵴角度两组,比较两组的分支闭塞发生率,应用多变量Logistic回归分析识别分支闭塞的独立预测因素。高界嵴角度组的分支闭塞发生率(61/597,10.2%)明显高于低界嵴角度组(27/603,4.5%)(p<0.01)。经多变量分析后证实:高界嵴角度是发生分支血管闭塞的独立预测因子(OR:1.024,95%CI:1.015-1.034,p<0.01)。结论高界嵴角度与分支闭塞发生率增高相关。既往关于低界嵴角度更易出现界嵴移位从而导致分支闭塞的假说有必要进一步探讨。
The displacement of the target plaque and border cristae may be the main cause of branch vessel occlusion. To confirm the relationship between the crista displacement and the occlusion of the branch, we compared the differences in the incidence of branch occlusion between two sets of fork lesions with different cristae angles. Methods and Results A total of 1,200 patients with bifurcation lesions were enrolled in this study. Both single-stent and double-stent strategies were used. The median of 31 ° as the boundary, the lesion is divided into two groups of high crest angle and low crest angle, compared the incidence of branch occlusion in both groups, using multivariate Logistic regression analysis to identify independent predictors of branch occlusion. The incidence of branch occlusion (61/597, 10.2%) in the high borderline group was significantly higher than that in the low borderline group (27/603, 4.5%) (p <0.01). Multivariate analysis confirmed that high cristae angle was an independent predictor of branch vessel occlusion (OR: 1.024, 95% CI: 1.015-1.034, p <0.01). Conclusions The angle of high crest is related to the increased incidence of branch occlusion. In the past, the hypothesis that the boundary of lower crest was more likely to appear transcumulative and leading to occlusion of the branch is necessary to be further explored.