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目的评价血管内超声(IVUS)指导下拘禁球囊分支保护联合单支架横跨技术治疗左主干分叉病变的临床疗效。方法 14例左主干真性分叉病变患者在IVUS指导下行左回旋支拘禁球囊保护及左主干-左前降支支架置入术,观察手术前后嵴部移位、斑块特点、回旋支血流情况及管腔直径/面积的变化。结果 IVUS测量支架置入前后左主干最小管腔面积分别为4.84±2.17mm2、10.23±2.77mm2,左前降支分别为2.94±1.52mm2、8.34±3.12mm2,均存在显著统计学差异。手术成功率100%,1例(7.1%)出现回旋支慢血流(TIMI血流1级),3例(21.4%)嵴部存在显著斑块负荷,8例(57.1%)发现明显的嵴部移位。结论左主干分叉病变应用拘禁球囊分支保护联合单支架横跨技术治疗是安全有效的。
Objective To evaluate the clinical effect of intravascular ultrasound (IVUS) guided detachment balloon branch protection combined with single stent cross technique in the treatment of left main bifurcation lesions. Methods Fourteen patients with left main trunk bifurcation underwent IVUS-guided left circumflex bronchiolysis and left main stem-left anterior descending stent placement. The changes of crest displacement, plaque characteristics and circumflex blood flow were observed before and after operation And lumen diameter / area change. Results The minimum lumen area of the left main trunk before and after IVUS measurement was 4.84 ± 2.17mm2 and 10.23 ± 2.77mm2, respectively, and the left anterior descending branch were 2.94 ± 1.52mm2 and 8.34 ± 3.12mm2, respectively. There were significant statistical differences. Surgical success rate was 100%. One case (7.1%) had supraclavicular flow (grade 1 TIMI flow), 3 cases (21.4%) had significant plaque burden, and 8 cases (57.1% Department shift. Conclusion Left main bifurcation lesion is safe and effective with interrupting balloon branch protection combined with single stent cross-over technique.