伍珩,蔺嫦燕

• 1:首都医科大学附属北京安贞医院生物医学工程研究室

摘要(Abstract)：

<正>随着冠心病介入治疗技术、介入设备的不断发展,冠状动脉分叉病变(coronary bifurcation lesion,CBL)在经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)中所占的比例呈现逐年上升的趋势。据欧洲分叉病变学会2016年统计显示,CBL占介入治疗的15%～20%[1]。CBL解剖结构复杂,与非分叉病变相比,CBL介入治疗手术难度大,手术即刻成功率低,术

关键词(KeyWords)： 冠状动脉分叉病变;经皮冠状动脉介入治疗;近端优化技术

Abstract:

Keywords:

基金项目(Foundation): 首都市民健康培育专项(Z161100000116086)

作者(Author): 伍珩,蔺嫦燕

参考文献(References)：

• [1]Lassen JF,Holm NR,Banning A,et al.Percutaneous coronary intervention f or coronary bif urcation disease:11th consensus document from the European Bifurcation Club.Euro Intervention,2016,12(1):38-46.
• [2]Yoshida T,Sakata K,Nitta Y,et al.Short-and long-term benefi ts of drug-eluting stents compared to bare metal stents even in treatment for large coronary arteries.Heart Vessels,2016,31(5):635-642.
• [3]Chen S,Zhang J,Ye F,et al.Crush stenting with paclitaxel-eluting or sirolimus-eluting stents for the treatment of coronary bifurcation lesions.Angiology,2008,59(4):475-483.
• [4]Park DW,Hong MK,Mintz GS,et al.Two-year follow-up of the quantitative angiographic and volumetric intravascular ultrasound analysis after nonpolymeric paclitaxel-eluting stent implantation:late“catch-up”phenomenon f rom ASPECT study.J Am Coll Cardiol,2006,48(12):2432-2439.
• [5]修建成，廖伟明，刘博，等.血管内超声分析左主干分叉病变主支植入支架后分支血管受累的原因.南方医科大学学报，2013,33(7):1045-1048.
• [6]Vassilev D,Gil R,Koo B,et al.The determinants of side branch compromise af ter main vessel stenting in coronary bif urcation lesions.Kardiol Pol,2012,70(10):989-997.
• [7]Finet G,Gilard M,Perrenot B,et al.Fractal geometry of arterial coronary bifurcations:a quantitative coronary angiography and intravascular ultrasound analysis.Euro Intervention,2008,3(4):490-498.
• [8]Louvard Y,Thomas M,Dzavik V,et al.Classifi cation of coronary artery bifurcation lesions and treatments:time for a consensus!Catheter Cardiovasc Interv,2008,71(2):175-183.
• [9]Steigen TK,Maeng M,Wiseth R,et al.Randomized study on simple versus complex stenting of coronary artery bif urcation lesions:the Nordic bifurcation study.Circulation,2006,114(18):1955-1961.
• [10]Colombo A,Moses JW,Morice MC,et al.Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions.Circulation,2004,109(10):1244-1249.
• [11]Pan M,De Lezo JS,Medina A,et al.Rapamycin-eluting stents for the treatment of bif urcated coronary lesions:a randomized comparison of a simple versus complex strategy.Am Heart J,2004,148(5):857-864.
• [12]Colombo A,Bramucci E,Sacca S,et al.Randomized study of the crush technique versus provisional side-branch stenting in true coronary bif urcations:the CACTUS(Coronary Bif urcations:Application of the Crushing Technique Using Sirolimus-Eluting Stents)study.Circulation,2009,119(1):71-78.
• [13]Ferenc M,Gick M,Kienzle RP,et al.Randomized trial on routine vs.provisional T-stenting in the treatment of de novo coronary bifurcation lesions.Eur Heart J,2008,29(23):2859-2867.
• [14]Hildick-Smith D,De Belder AJ,Cooter N,et al.Randomized trial of simple versus complex drug-eluting stenting for bifurcation lesions:the British Bifurcation Coronary Study:old,new,and evolving strategies.Circulation,2010,121(10):1235-1243.
• [15]Song YB,Hahn JY,Song PS,et al.Randomized comparison of conservative versus aggressive strategy for provisional side branch intervention in coronary bif urcation lesions:results f rom the SMART-STRATEGY(Smart Angioplasty Research Team-Optimal Strategy for Side Branch Intervention in Coronary Bif urcation Lesions)randomized trial.JACC Cardiovasc Interv,2012,5(11):1133-1140.
• [16]Maeng M,Holm NR,Erglis A,et al.Long-term results after simple versus complex stenting of coronary artery bif urcation lesions:Nordic Bif urcation Study 5-year follow-up results.J Am Coll Cardiol,2013,62(1):30-34.
• [17]Neumann FJ,Sousa-Uva M,Ahlsson A,et al.2018 ESC/EACTSGuidelines on myocardial revascularization.Eur Heart J,2019,40(2):87-165.
• [18]罗永百，黄欣，钟钟，等.血管内超声指导单支架术式处理左主干分叉病变1年随访结果分析.中国介入心脏病学杂志，2019,27(5):249-252.
• [19]Chen SL,Sheiban I,Xu B,et al.Impact of the complexity of bif urcation lesions treated with drug-eluting stents:the DEFINITION study(Defi nitions and impact of complex bifurcation lesions on clinical outcomes after percutaneous coronary intervention using drug-eluting stents).JACC Cardiovasc Interv,2014,7(11):1266-1276.
• [20]Lefèvre T,Morice M,Sengottuvel G,et al.Infl uence of technical strategies on the outcome of coronary bif urcation stenting.Euro Intervention,2005,1(1):31-37.
• [21]Nakamura S,Hall P,Maiello L,et al.Techniques for PalmazSchatz stent deployment in lesions with a large side branch.Cathet Cardiovasc Diagn,1995,34(4):353-361.
• [22]Nakazawa G,Yazdani SK,Finn AV,et al.Pathological fi ndings at bifurcation lesions:the impact of fl ow distribution on atherosclerosis and arterial healing after stent implantation.J Am Coll Cardiol,2010,55(16):1679-1687.
• [23]Suarez De Lezo J,Medina A,Martin P,et al.Predictors of ostial side branch damage during provisional stenting of coronary bif urcation lesions not involving the side branch origin:an ultrasonographic study.Euro Intervention,2012,7(10):1147-1154.
• [24]Xu J,Hahn JY,Song YB,et al.Carina shift versus plaque shift for aggravation of side branch ostial stenosis in bifurcation lesions:volumetric intravascular ultrasound analysis of both branches.Circ Cardiovasc Interv,2012,5(5):657-662.
• [25]Burzotta F,Mortier P,Trani C.Characteristics of drug-eluting stent platforms potentially infl uencing bifurcated lesion provisional stenting procedure.Euro Intervention,2014,10(1):124-132.
• [26]David HS,Jens Flensted L,Remo A,et al.Consensus from the 5th European Bifurcation Club meeting.Euro Intervention,2010,6(1):34-38.
• [27]Darremont O,Leymarie JL,Lefevre T,et al.Technical aspects of the provisional side branch stenting strategy.Euro Intervention,2015,11(Suppl V):V86-V90.
• [28]Murasato Y,Iwasaki K,Yamamoto T,et al.Optimal kissing balloon inflation after single-stent deployment in a coronary bifurcation model.Euro Intervention,2014,10(8):934-941.
• [29]Foin N,Torii R,Mortier P,et al.Kissing balloon or sequential dilation of the side branch and main vessel for provisional stenting of bif urcations:lessons from micro-computed tomography and computational simulations.JACC Cardiovasc Interv,2012,5(1):47-56.
• [30]Mylotte D,Routledge H,Harb T,et al.Provisional side branchstenting for coronary bifurcation lesions:evidence of improving procedural and clinical outcomes with contemporary techniques.Catheter Cardiovasc Interv,2013,82(4):E437-E445.
• [31]Matsuda Y,Ashikaga T,Sasaoka T,et al.Eff ectiveness of the proximal optimization technique for longitudinal stent elongation caused by post-balloon dilatation.J Interv Cardiol,2018,31(5):624-631.
• [32]Hanratty CG,Walsh SJ.Longitudinal compression:a“new”complication with modern coronary stent platforms--time to think beyond deliverability?Euro Intervention,2011,7(7):872-877.
• [33]Hakim D,Chatterjee A,Alli O,et al.Role of proximal optimization technique guided by intravascular ultrasound on stent expansion,stent symmetry index,and side-branch hemodynamics in patients with coronary bifurcation lesions.Circ Cardiovasc Interv,2017,10(10).
• [34]Yang JH,Lee JM,Park TK,et al.The proximal optimization technique improves clinical outcomes when treated without kissing ballooning in patients with a bifurcation lesion.Korean Circ J,2019,49(6):485-494.
• [35]Finet G,Derimay F,Motreff P,et al.Comparative analysis of sequential proximal optimizing technique versus kissing balloon inflation technique in provisional bif urcation stenting:f ractal coronary bifurcation bench test.JACC Cardiovasc Interv,2015,8(10):1308-1317.
• [36]Derimay F,Finet G,Souteyrand G,et al.Benefit of a new provisional stenting strategy,the re-proximal optimisation technique:the re POT clinical study.Euro Intervention,2018,14(3):e325-e332.
• [37]Foin N,Secco GG,Ghilencea L,et al.Final proximal postdilatation is necessary after kissing balloon in bifurcation stenting.Euro Intervention,2011,7(5):597-604.
• [38]Murasato Y,Mori T,Okamura T,et al.Effi cacy of the proximal optimization technique on crossover stenting in coronary bifurcation lesions in the 3D-OCT bifurcation registry.Int J Cardiovasc Imaging,2019,35(6):981-990.
• [39]Derimay F,Rioufol G,Cellier G,et al.Benefi ts of fi nal proximal optimization technique(POT)in provisional stenting.Int J Cardiol,2019,274:71-73.
• [40]Mortier P,Wentzel JJ,De Santis G,et al.Patient-specifi c computer modelling of coronary bifurcation stenting:the John Doe programme.Euro Intervention,2015,11(Suppl V):V35-V39.
• [41]Jorgensen E,Helqvist S.Stent treatment of coronary artery bifurcation lesions.Eur Heart J,2007,28(4):383-385.
• [42]Rigatelli G,Zuin M,Dell'avvocata F,et al.Evaluation of coronary flow conditions in complex coronary artery bifurcations stenting using computational fluid dynamics:Impact of final proximal optimization technique on diff erent double-stent techniques.Cardiovasc Revasc Med,2017,18(4):233-240.
• [43]Costa RA,Mintz GS,Carlier SG,et al.Bifurcation coronary lesions treated with the“crush”technique:an intravascular ultrasound analysis.J Am Coll Cardiol,2005,46(4):599-605.
• [44]Ge L,Airoldi F,Iakovou I,et al.Clinical and angiographic outcome after implantation of drug-eluting stents in bifurcation lesions with the crush stent technique:importance of fi nal kissing balloon post-dilation.J Am Coll Cardiol,2005,46(4):613-620.
• [45]Burzotta F,Gwon HC,Hahn JY,et al.Modifi ed T-stenting with intentional protrusion of the side-branch stent within the main vessel stent to ensure ostial coverage and facilitate fi nal kissing balloon:the T-stenting and small protrusion technique(TAP-stenting).Report of bench testing and fi rst clinical Italian-Korean two-centre experience.Catheter Cardiovasc Interv,2007,70(1):75-82.
• [46]Foin N,Alegria-Barrero E,Torii R,et al.Crush,culotte,T and protrusion:which 2-stent technique for treatment of true bifurcation lesions?-insights from in vitro experiments and micro-computed tomography.Circ J,2013,77(1):73-80.