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在冠状动脉分支病变中,使用一支或两支支支架的支架策略

Zachary Chan¹, Michaella Alexandrou², Dimitrios Strepkos²

¹Cornell University, Ithaca, New York; Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota.

The Journal of invasive cardiology

|September 10, 2025

概括

一个支架与两支支架在分叉穿皮冠状动脉干预 (PCI) 中显示了类似的长期结果. 这项研究比较了冠状动脉分支中PCI的1-stent和2-stent策略.

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) 对于治疗冠状动脉疾病至关重要.
两叉病变在PCI中存在独特的挑战,通常需要复杂的支架策略.
在双叉PCI中,对1-stent与2-stent技术的比较结果数据仍然有限.

研究的目的:

为了比较手术特征和临床结果的前期1-stent与2-stent策略在双叉PCI.
评估长期随访结果,包括主要心脏不良事件 (MACE),用于两种支架方法.

主要方法:

从PROGRESS-BIFURCATION注册表 (2014-2024) 中分析了1306个分支的PCI.
分类为前期1支支支架 (主要是临时支架) 和前期2支支架策略 (例如,双吻粉碎,culotte).
血管造影,手术数据和临床结果的比较,平均随访时间长达3年.

主要成果:

在75.5%的病变中使用了前置1支支支架PCI,而在24.5%的病变中使用了2支架PCI.
两支支支架的策略与更长的手术/光学时间和更高的辐射剂量相关,但具有相似的对比度.
技术上的成功率高于2支支支架策略 (98.4% vs 94.4%),但程序上的成功率和医院内MACE的成功率相似.
在平均3年的随访期内,与1支支支架策略相比,使用2支架策略治疗的患者表现出类似的MACE,TVR,MI和全因死亡率.

结论:

前置1支干细胞和2支干细胞分支PCI技术显示了可比的程序成功和长期临床结果.
在选择1支支支架和2支支架的策略之间,应考虑病变的复杂性和程序因素,因为长期的结果似乎相似.

关键词:

两叉病变的病变是分叉的病变.通过皮肤进行冠状动脉干预.

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