刘巍,周玉杰,刘宇扬,吕树峥,陈方,李志忠

• 1:北京首都医科大学附属北京安贞医院心内科

摘要(Abstract)：

目的本文总结桥血管吻合口病变的介入治疗特点及临床预后。方法 2005年12月至2011年12月在北京安贞医院行桥血管吻合口经皮冠状动脉介入治疗(PCI)的44例患者(47个病变)中,位于左侧内乳动脉桥远端吻合口病变9个,主动脉-静脉桥开口病变19个,静脉桥远端吻合口病变19个。临床观察终点为不良心血管事件(MACE),包括心性死亡、靶病变再次血运重建(TLR)、急性心肌梗死(AMI)。结果平均桥血管病变发生时间中位数为冠状动脉旁路移植术后5年(2个月～14年),总介入成功率为75.5%,左侧内乳动脉吻合口PCI的介入成功率为77.8%,主动脉-静脉桥开口的介入成功率为68.4%,静脉桥远端吻合口的介入成功率为78.9%。72%的病变置入药物洗脱支架(DES)。住院期间,主动脉-静脉桥开口患者3例死亡。患者平均随访中位数30个月,靶病变狭窄或闭塞(TLF)8例,占所有介入成功病例的22.8%,其中5例(14.3%)行TLR。随访30个月,累积无MACE生存率在左侧内乳动脉桥远端吻合口病变患者中为85.7%,主动脉-静脉桥开口病变为60.7%,静脉桥远端吻合口病变为94.1%。结论桥血管吻合口介入手术可行,以静脉桥主动脉开口病变的介入治疗成功率低,静脉桥远端吻合口病变置入DES的远期预后较好。

关键词(KeyWords)： 心肌桥;冠状血管;血管成形术,经腔,经皮冠状动脉

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘巍,周玉杰,刘宇扬,吕树峥,陈方,李志忠

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