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目的:评价雷帕霉素洗脱支架(CYPHERTM支架)治疗冠状动脉分叉病变的近、远期疗效。方法:76例冠状动脉分叉病变且有临床缺血症状的患者接受了主支CYPHERTM支架及分支血管球囊扩张术,术后对患者进行临床随访及冠状动脉造影复查,回顾性分析其结果。结果:76例中有35例行吻合球囊扩张术,主支无残余狭窄或残余狭窄<10%,分支残余狭窄<50%,住院期间无严重并发症如支架内血栓形成、急性心肌梗死、紧急外科冠状动脉搭桥术或死亡等。患者平均随访时间(8.3±1.9)个月,有1例患者心绞痛复发,无心肌梗死或死亡。冠状动脉造影的随访率81.6%,主支平均晚期管腔丢失(0.08±0.02)mm,分支血管晚期管腔丢失(0.20±0.05)mm。靶血管血运重建率5.26%。结论:应用主支CYPHERTM支架和分支血管球囊扩张的方法治疗分叉病变安全、可行,并可有效防止主支血管再狭窄。
Objective: To evaluate the short-term and long-term effects of rapamycin-eluting stent (CYPHERTM) in the treatment of coronary bifurcation lesions. Methods: Sixty-six patients with coronary artery bifurcation and clinical symptoms of ischemia underwent primary balloon CYPHERTM and branch balloon dilatation. Postoperative follow-up and coronary angiography were performed on patients. The results were retrospectively analyzed. Results: Of 76 cases, 35 cases underwent anastomosis balloon dilatation. The main branch had no residual stenosis or residual stenosis <10%, residual stenosis of branch <50%. There were no serious complications during hospitalization such as stent thrombosis, acute myocardial infarction, Emergency surgical coronary bypass surgery or death and so on. The average follow-up time was 8.3 ± 1.9 months. One patient had recurrent angina without myocardial infarction or death. The follow-up rate of coronary angiography was 81.6%. The average length of the main branch was 0.08 ± 0.02 mm, and the late branch of the branch was lost (0.20 ± 0.05) mm. Target vessel revascularization rate was 5.26%. Conclusion: It is safe and feasible to treat the bifurcation lesion with the main branch CYPHERTM stent and branch vessel balloon dilatation. And it can effectively prevent the main vessel restenosis.