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目的:评价不同介入方法治疗冠状动脉前降支分叉病变的近、中期疗效。方法:39例经冠脉造影证实左冠前降支分叉病变的患者,接受了主支植入支架,分支分别采用无钢丝保护、钢丝保护、对吻球囊扩张术、Crush技术或改良Crush技术,术后对患者进行临床随访,回顾性分析其结果。结果:39例患者共植入支架56枚,药物支架21枚,其中前降支药物支架15枚。分支与主支对吻球囊扩张11例,其中2例对吻球囊扩张失败;Crush技术或改良Crush技术5例,其中1例未完成对吻扩张。术毕主支血管无残余狭窄或残余狭窄<10%,3例分支血管残余狭窄>50%,手术成功率为92.3%(36/39),无严重急性并发症出现。住院期间无主要心脏不良事件(MACE)发生,随访期间MACE发生率为2.6%(1/39)。结论:根据冠脉分叉病变的病理分型采用不同的介入治疗方法是安全、可行的,并且近中期临床疗效较好。
Objective: To evaluate the short-term and long-term effects of different interventional methods in the treatment of anterior descending coronary artery bifurcation lesions. Methods: Thirty-nine patients with left anterior descending branch bifurcation lesion confirmed by coronary angiography underwent stent-graft. The branches were treated with no wire protection, wire protection, kiss balloon dilation, Crush technique or modified Crush Technology, clinical follow-up of patients, retrospective analysis of the results. Results: A total of 56 scaffolds and 21 scaffolds were implanted in 39 patients, of which 15 were scaffolds of anterior descending artery. Branch and main anastomosis balloon dilation in 11 cases, of which 2 cases of kiss balloon dilatation failure; Crush technology or modified Crush technology in 5 cases, 1 case did not complete kiss expansion. There was no residual stenosis or residual stenosis <10%, residual stenosis of 3 branches in 50%, and the successful rate of operation was 92.3% (36/39). No serious acute complications occurred. No major adverse cardiac events (MACEs) occurred during hospitalization, with a MACE incidence of 2.6% (1/39) during follow-up. Conclusion: It is safe and feasible to use different interventional methods according to the pathological type of coronary bifurcation lesion, and the curative effect in the near and mid-term is good.