A Preliminary Study on the Efficacy of Percutaneous Coronary Intervention for Complex Left Main Stem Combined With Chronic Total Occlusion of the Right Coronary Artery
10.3969/j.issn.1000-3614.2024.06.005
- VernacularTitle:合并右冠状动脉慢性闭塞的复杂左主干行经皮冠状动脉介入治疗疗效的初步探讨
- Author:
Zun HU
1
;
Hu HU
;
Yubo LONG
;
Junshan LI
;
Jingjing RONG
;
Jin HE
;
Changlu WANG
;
Yu ZHANG
;
Jianqiang PENG
;
Hongwei PAN
Author Information
1. 湖南省人民医院(湖南师范大学附属第一医院)湖南省心力衰竭临床医学研究中心 心血管内科,长沙 410005
- Keywords:
complex left main lesion;
chronic total occlusion of right coronary artery;
percutaneous coronary intervention
- From:
Chinese Circulation Journal
2024;39(6):562-567
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:to analyze the efficacy of percutaneous coronary intervention(PCI)for complex left main(LM)lesions combined with chronic total occlusion(CTO)of the right coronary artery. Methods:Ninety patients with complex left main lesions hospitalized in Hunan Provincial People's Hospital from January 2019 to December 2022 were consecutively included.According to the coronary angiographic vascular lesions,patients were divided into complex left main lesions combined with right coronary artery CTO(observation group,n=30)and complex left main lesions without right coronary artery CTO(control group,n=60).The baseline clinical data,intraoperative conditions,angiographic results,and postoperative follow-up results of the patients were analyzed and compared between the two groups. Results:Fifty-eight(64.4%)out of the 90 patients were male.There was no statistically significant difference between the two groups in terms of baseline clinical data(all P>0.05),left main lesion condition(P=1.000),left main calcification condition(P=0.249),and preoperative TIMI flow grading(P=1.000).In the comparison between observation group and the control group,intraoperative occurrence of no-reflow(3.3%vs.5.0%,P=1.000),hypotension(10.0%vs.8.3%,P=1.000),pericardial effusion(3.3%vs.0%,P=0.333),the percentage of intravascular ultrasound(IVUS)use(86.7%vs.90.0%,P=0.635),and the use of circulatory assist device(P=0.699),and the proportion of intraoperative coronary spinning(26.7%vs.21.7%,P=0.597)were all similar between the two groups.The median follow-up time was 14.50(11.83,15.85)months,and the differences in the incidence of major adverse cardiovascular events(MACE)such as recurrent angina,acute myocardial infarction,rebleeding,readmission for heart failure,and cardiac death(31.0%vs.32.1%,P=1.000)were not statistically significant between the observation group and the control group. Conclusions:PCI revascularization may be a viable approach for elderly patients with complex LM lesions with multiple underlying disease,and combined right coronary artery CTO,intolerance and reluctance to CABG.
