DK Culotte 支架技术在冠脉分叉病变中的应用
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Transcript of DK Culotte 支架技术在冠脉分叉病变中的应用
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DK Culotte 支架技术在冠脉分叉病变中的应用
胡 涛
第四军医大学西京医院心内科
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冠脉介入手术中分叉病变的处理仍然
没有理想的方案。
目前已成为全球冠心病介入治疗学的
研究热点。
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在双支架植入术式中 , Culotte 技术得
到了广泛的应用,但仍然有其局限性。
因此我们设计了改良的两次球囊对吻
(DK) 方法以期能获得更佳的 Culotte
技术效果 。
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FIRST KISSING
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DOUBLE KISSING
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FINAL RESULTS
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为了验证此改良方法的效果,我们设计了前瞻随机对照试验,对 DK 和经典 Culotte 技术进行了最终球囊对吻率
(FKBI) 以及长期临床随访结果的比较。
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方法
真性分叉病变患者(麦迪兰分型 1 , 1 ,
1 )随机分为 DK 或经典 Culotte 组植
入药物洗脱支架。
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6-9 月期间进行冠脉造影复查。
临床随访持续到 12 个月。
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结 果
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58 59 6163
0
10
20
30
40
50
60
70
80
Classical DK
Patients
Lesions
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P <0.001F
KB
I (%
)
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P <0.01U
nsa
tisf
acto
ry
FK
BI
(%)
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P <0.001R
este
nos
is (
%)
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P =0.001M
AC
E (
%)
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结论 DK Culotte 技术提高了最终球囊对吻率,
冠脉造影复查再狭窄率低于经典 Culotte 技术。
长期临床随访结果显示 DK Culotte 技术组有着更佳的临床结果。
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致 谢
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Double-Kissing Culotte Stenting Technique in Coronary
Bifurcation Disease
Hu, Tao
Department of Cardiovascular Medicine Xijing Hospital, the Fourth Military Medical
University
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Percutaneous treatment of coronary
bifurcation disease remains challenging.
Optimal treatment with percutaneous
coronary intervention (PCI) for
bifurcation lesions has not yet been
achieved.
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In patient subsets in which a two-stent strategy
is necessary, the culotte technique is a widely
used method. However, this technique has its
own limitations.
We therefore developed a double kissing (DK)
balloon method to optimize the final result of
culotte stenting.
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FIRST KISSING
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DOUBLE KISSING
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FINAL RESULTS
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To study this technique, and to compare it with
the classical culotte technique, we performed a
prospective, randomized trial aimed at
determining the differences in the rates of final
kissing balloon inflation (FKBI) and long-term
clinical outcomes at our institution.
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Methods
We prospectively enrolled patients undergoing PCI of a true coronary bifurcation lesion with a Medina classification of (1, 1, 1) with drug-eluting stents in our institution.
Patients were randomly assigned to undergo treatment using either the classical Culotte stenting or the DK Culotte stenting technique.
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Angiographic follow-up was scheduled
between 6 and 9months. Clinical
follow-up was available up to 12
months.
All patients underwent follow-up by
telephone or clinic review.
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Results
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58 59 6163
0
10
20
30
40
50
60
70
80
Classical DK
Patients
Lesions
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P <0.001F
KB
I (%
)
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P <0.01U
nsa
tisf
acto
ry
FK
BI
(%)
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P <0.001R
este
nos
is (
%)
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P =0.001M
AC
E (
%)
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Conclusion
The DK Culotte stenting technique is associated with high procedural success by optimizing the FKBI rates and by allowing a complete stent expansion at the side branch ostium and a relatively low risk of angiographic restenosis.
The improved clinical outcomes were sustained even at a 12 month follow-up period.
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THANKS