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目前为数不多的随机研究表明与单支架技术相比,分叉病变介入治疗中双支架技术并未提供更多的益处。在主支血管内置入支架,必要时在分支血管内置入另一枚支架(Provision T支架术)仍然是分叉病变介入治疗中较为常用的治疗策略。但在临床实践中,仍有20%～30%的真性分叉病变需双支架技术,即便是在药物洗脱支架时代,双支架技术的应用也不应减少。如果病变弥漫性累及分支血管开口部位和近中段血管,分支血管直径>2.5mm且供血范围较大,术者应选择双支架技术。目前尚无资料表明与单支架技术相比,双支架技术增加支架内血栓发生率。在采用双支架技术时,必须完全覆盖病变和进行最终球囊对吻。患者对双重抗血小板药物的依从性在改善患者的预后方面起至关重要的作用。
At present, a small number of randomized studies have shown that dual stent technology does not provide more benefit in bifurcation interventional therapy than single stent technology. The placement of stents in the main branch and, if necessary, placement of another stent in the branch vessels (Provision T stenting) remains the more common treatment strategy for bifurcated lesions. However, in clinical practice, there are still 20% to 30% of true bifurcation lesions requiring double scaffold technology, even in the era of drug-eluting stents, the application of dual scaffold technology should not be reduced. If the lesion diffusely affects the opening of the branch vessel and the proximal and middle vessels, the diameter of the branch vessel is larger than 2.5 mm and the blood supply area is larger, the surgeon should choose the double stent technique. There is no data available to show that dual stent technology increases the incidence of stent thrombosis compared to single stent technology. With dual-stent technology, the lesions must be completely covered and the final balloon kissing must be completed. Patient compliance with dual antiplatelet drugs plays a crucial role in improving the patient’s prognosis.