Effects of treating ostial left anterior descending artery stenosis by drug eluting stents via precisely positioning or crossing over into left main stem
10.3321/j.issn:0253-3758.2008.02.004
- VernacularTitle:药物洗脱支架精确定位与贯穿左冠状动脉主干治疗冠状动脉前降支口部病变的对照研究
- Author:
Zhan GAO
1
;
Yue-Jin YANG
;
Ji-Lin CHEN
;
Shu-Bin QIAO
;
Bo XU
;
Xue-Wen QIN
;
Min YAO
;
Hai-Bo HU
;
Yong-Jian WU
;
Jin-Qing YUAN
;
Jue CHEN
;
Shi-Jie YOU
;
Jian-Jun LI
;
Run-Lin GAO
Author Information
1. 中国医学科学院中国协和医科大学北京协和医院
- Keywords:
Coronary disease;
Angioplasty;
transluminal;
percutaneous coronary;
Stents;
Ostial lesion;
left anterior descending artery
- From:
Chinese Journal of Cardiology
2008;36(2):113-117
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effect of treating ostial left anterior descending artery (LAD)stenosis using drug-eluting stents(DES)by precisely positioning versus crossing over into left main (LM)technique.Methods From April 2004 to May 2006,DES implantations in 224 consecutive patients with ostial LAD lesions were performed by precisely positioning in 161 patients(P group)and crossing over into LM in 63 patients(C group).Clinical and angiographic follow-up was performed at 7 months post DES implantations.Results Relevant vessel diameter(RVD)was significantly larger(3.44±0.52 mm vs. 3.17±0.40 mm,P=0.039)and LM/LAD diameter ratio was significantly lower(1.16±0.07 vs.1.28± 0.05,P=0.000)in C group compared that in P group.Stent(3.53±0.31 mm vs.3.16±0.29 mm,P=0.035)and postdititation balloon(3.59±0.65 mm vs.3.24±0.32 mm,P=0.035)diameter were significantly larger and postdilitation(94.1%vs.29.5%,P=0.000)and kissing balloon(47.1%vs.15.2%,P=0.000)rates were significantly higher in P group than that in C group.Both groups achieved 100%Droeedure success rate.Major adverse cardiac events(MACE)rate(4.3%vs.1.6%,P=0.447),death(0 vs.0,P=1.000),AMI(1,2%vs.1.6%,P=1.000)and target vessel revascularization (TVR)rate(3.1%vs.0%,P=0.325)were similar between the 2 groups.One patient in P group developed subacute in-stent thrombosis.Follow-up angiography at 7 months showed that in-stent(0 vs.7.7%,P=0.316)and in-segment restenosis rate(3.8%vs.10.8%,P=0.431)tended to be lower while in-stent(0.12±0.08 mm vs.0.59±0.37 mm,P=0.000)and in-segment(0.17±0.09 mm vs.0.64±0.49 mm,P=0.000)late loss were significantly lower in C group compared with P group.Conclusion Compared with precisely positioning technique,crossing over into LM technique was more feasible and tended to reduce restenosis rate for ostial LAD lesions treated with DES.
