双吻粉碎与 culotte 对于分叉穿皮冠状动脉干预:来自 PROGRESS-BIFURCATION 注册表的见解
Deniz Mutlu1, Dimitrios Strepkos1, Pedro E Carvalho1
1Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota.
The Journal of invasive cardiology
|January 14, 2025
概括
冠状动脉分支穿皮冠状动脉干预 (PCI) 的双吻 (DK) 压碎技术表现出类似于culotte技术的程序成功,但显著降低了长期不良事件和再血管化需求.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 穿皮冠状动脉干预 (PCI) 在分叉处通常采用前期的2支支支架策略.
- 最佳的技术选择仍然是争论的主题.
研究的目的:
- 为了比较双吻 (DK) 的临床,血管学和长期结果,在 PCI.
- 评估这些两支支支架方法的安全性和有效性.
主要方法:
- 一个前性注册表 (NCT05100992) 确定了232例双叉PCI病例 (216名患者) 使用DK粉碎或割技术 (2014-2023年).
- 治疗权重的逆概率 (IPTW) 考克斯分析用于比较长期结果.
- 分析了临床和血管学数据.
主要成果:
- DK粉碎更频繁地使用 (69.0%) 并与左主冠状动脉病变和更严重的化有关.
- 在DK crush和culotte组之间,技术成功,程序成功和住院MACE是相似的.
- 在平均43个月的随访期间,DK crush与culotte相比,随访MACE (HR 0.28) 和目标血管再血管化 (TVR) 显着较低.
结论:
- 在二叉PCI中,DK的粉碎和割技术提供了可比的周边过程结果.
- DK粉碎与优异的长期结果有关,包括减少MACE和TVR.
- 在复杂的双叉病变中,DK粉碎可能是首选的策略.
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