Jailed 球囊保护在冠状动脉分叉病变处理中的初步应用

目的：探讨Jailed球囊技术在冠状动脉分叉病变主支血管支架加分支血管备选T-支架处理中的作用。方法对57例接受主支血管支架加分支血管备选T-支架治疗的患者临床资料和冠状动脉介入治疗过程记录的DICOM格式的造影录像进行分析，测定治疗前后主支血管病变处与分支血管开口的最小直径、主支与分支血管夹角，计算术前和术后变化差值，并作Jailed球囊与Jailed导丝组之间的比较。结果共有57例60个分叉病变接受Jailed导丝（39例）或Jailed球囊（18例）分支保护下的主支血管支架植入手术。Jailed导丝组发生分支血管闭塞3例，TIMI血流≤2级的5例，Jailed球囊组分支血管闭塞1例。分支血管开口最小直径术后与术前变化差值Jailed导丝组为（-0.34±0.39）mm，Jailed球囊组为（0.08±0.64）mm，差异有显著统计学意义（t=3.144，P＜0.01）。分叉血管夹角术后Jailed导丝组缩小，Jailed球囊组增大，变化值差异有显著统计学意义（-3.82±9.04）°、（3.54±7.76）°；t=3.102，P＜0.01]。结论在冠状动脉分叉病变主支血管支架加分支血管备选T-支架治疗中，Jailed球囊技术有利于防范分支血管开口严重挤压甚或闭塞的发生。

Application of Jailed bal oon protection in the treatment of bifurcation coronary lesions

Objective To investigate the effects of Jailed balloon technique on the bifurcation lesions treated with main branch （MB） stent and provisional T- stent of side branch （SB）. Methods The clinical data and coronary angiography recorded in DICOM format during coronary intervention were analyzed in 57 patients treated with MB stent and provisional T- stent of SB. The minimum luminal diameter （MLD） of MB lesions and SB ostium, bifurcation angle between MB and SB were measured before and after coronary procedure. The difference values of these parameters before and after the procedure were calculated and compared between Jailed bal oon and Jailed wire groups. Results 60 bifurcation lesions in 57 patients underwent MB stent implantation with the protection of SB by Jailed wire （39 cases） or Jailed bal oon （18 cases）. SB occluded in 3 cases and TIMI flow reduced to 2 in 5 cases in Jailed wire group. SB occluded in 1 case in Jailed bal oon group. The difference value of SB ostial MLD before and after procedure was- 0.34±0.39 mm in Jailed wire group and 0.08±0.64 mm in Jailed bal oon group. There was significant difference between them （t=3.144, P〈0.01）. The angle between MB and SB reduced in Jailed wire group and increased in Jailed bal oon group after the procedure and the difference value between groups was significantly different（- 3.82±9.04）°vs （3.54±7.76）°, t=3.102, P〈0.01]. Conclusion Jailed balloon technique is in favour of avoiding SB compromise or occlusion during the treatment of bifurcation lesions with MB stent implantation and provisional T- stent of SB.