改良T支架技术治疗左冠状动脉主干末端分叉病变的临床疗效

目的探讨左冠状动脉主干末端分叉狭窄患者行择期改良T支架技术冠状动脉介入（PCI）治疗的安全性和可行性。方法回顾分析白求恩国际和平医院心内科2004年1月～2007年11月间，行改良T支架技术治疗的16例左冠状动脉主干末端分叉狭窄患者的临床情况、冠状动脉病变特点、介入治疗特点、住院期间主要心脏不良事件和术后6个月心绞痛和生活质量情况。结果16例患者年龄46～68岁，男性13例，合并糖尿病7例，有心肌梗死病史6例。左冠状动脉主干直径3．5～5．0mm，前降支（taD）直径2．75～3．5mm，回旋支（LCX）直径2．75～3．5mm，LAD病变长度13—22mm，LCX病变长度13～20mm。LAD支架释放压力12—20个大气压，LCX支架释放压力12～18个大气压，对吻球囊技术100％，2例经桡动脉途径、14例经股动脉途径成功完成改良T支架置入术，PCI即刻成功率为100％，手术时间40～60（平均48）min。住院期间无严重并发症发生，术后6个月临床随访心绞痛显著缓解，生活质量显著提高。结论改良T支架技术治疗左冠状动脉主干末端分叉病变，成功率高，安全有效。

Clinical outcomes of treating left main bifurcation lesions with modified T-stent technique

Objective To assess the safety and availability of modified T-stent technique for patients with left main coronary artery bifurcation lesions. Methods 16 patients with left main coronary artery bifurcation lesions were performed with modified T-stent technique, some parameters, such as clinical states, characteristics of coronary artery lesions and coronary complications interventions and in-hospitalization were examined. Results The patients were 46 - 68 years old. The diameter of the left main were 3.5 - 5.0 mm, the diameter of left anterior descending（LAD） and left circumflex artery（LCX） were 2.75 -3.5 mm and 2.75 - 3.5 mm. The lesion length of LAD and LCX were 13 - 22 mm and 13 - 20 mm. The stent dilating pressure in LAD and LCX were 12 - 20 atmosphere and 12 - 18 atmosphere. Kissing balloon technique was used in all cases. Modified T-stent technique primary success rate was 100%. The operation time was 40 - 60 minutes. Conclusion Modified T-stent technique for patients with left main bifurcation lesions is safe and effective, with high success rate.