有或没有分支的简单支架策略 冠状动脉分叉病变治疗的骨优化技术
En Chen1, Wei Cai1, Linlin Zhang1
1Department of Cardiology, Fujian Heart Medical Center, Fujian Medical University Union Hospital, Fujian Institute of Coronary Artery Disease, Fujian Institute of Geriatrics, 350001 Fuzhou, Fujian, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
与POT相关技术 (POTAs) 相比,一种新的分支骨优化技术 (BOOT) 在冠状动脉分支病变 (CBLs) 中显示出改善的血管检查结果和减少主要不良心脏事件 (MACE). 在复杂的支架程序中,BOOT为优化侧枝骨提供了一个有希望的替代方案.
科学领域:
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
- 生物医学工程 生物医学工程
背景情况:
- 冠状动脉分支病变 (CBL) 通常用临时侧枝 (SB) 或交叉支架进行治疗.
- 靠近优化技术 (POT) 和相关技术 (POTA) 旨在优化SB ostia,但在减少被囚禁的支柱和血管损伤方面存在局限性.
- 为了解决这些局限性,开发了一种新的分支骨优化技术 (BOOT).
研究的目的:
- 评估新型分支骨优化技术 (BOOT) 对冠状动脉分叉病变的疗效和安全性.
- 使用倾向分数匹配 (PSM) 将BOOT与POT相关技术 (POTA) 进行比较.
- 在12个月的随访期评估血管学和临床结果.
主要方法:
- 在2016年6月至2018年3月期间,共有203名真正的CBL患者连续接受了BOOT (50名患者) 或POTA支架 (153名患者) 的治疗.
- 进行倾向分数匹配 (PSM),以调整临床和病变特征,结果每组43名患者.
- 主要终点是12个月的累积主要不良心脏事件 (MACE),包括心脏死亡,心肌梗塞,目标血管/损伤重血管化 (TVR/TLR) 和目标血管/损伤血栓形成 (ST).
主要成果:
- 在PSM后,与POTA组相比,BOOT组在近端主分支 (20.01%对26.81%),远端主分支 (18.07%对23.44%) 和侧侧分支 (23.53%对39.01%) 的血管图像复缩率显著降低.
- 12个月后MACE的发病率在PSM后的BOOT组明显较低 (4.7%对23.3%,p=0.026),主要是由于TVR/TLR的减少 (2.3%对20.9%,p=0.015).
- 在89.5%的患者中,进行了随访冠状动脉血管学.
结论:
- 新的分支骨优化技术 (BOOT) 是可行的优化侧支骨在冠状动脉分叉病变的患者.
- 在12个月的随访中,BOOT在血管学测量方面表现出优于POT相关技术 (POTAs).
- 与POTA相比,BOOT可能为治疗冠状动脉分支病变提供更好的长期临床结果.
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