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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. 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。. 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 。. FIRST KISSING. DOUBLE KISSING. FINAL RESULTS. - PowerPoint PPT Presentation
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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
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。
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 。
FIRST KISSING
DOUBLE KISSING
FINAL RESULTS
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。
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。
6-9 月期间进行冠脉造影复查。
临床随访持续到 12 个月。
结 果
58 59 6163
0
10
20
30
40
50
60
70
80
Classical DK
Patients
Lesions
P <0.001F
KB
I (%
)
P <0.01U
nsa
tisf
acto
ry
FK
BI
(%)
P <0.001R
este
nos
is (
%)
P =0.001M
AC
E (
%)
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。
致 谢
Double-Kissing Culotte Stenting Technique in Coronary
Bifurcation Disease
Hu, Tao
Department of Cardiovascular Medicine Xijing Hospital, the Fourth Military Medical
University
Percutaneous treatment of coronary
bifurcation disease remains challenging.
Optimal treatment with percutaneous
coronary intervention (PCI) for
bifurcation lesions has not yet been
achieved.
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.
FIRST KISSING
DOUBLE KISSING
FINAL RESULTS
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.
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.
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.
Results
58 59 6163
0
10
20
30
40
50
60
70
80
Classical DK
Patients
Lesions
P <0.001F
KB
I (%
)
P <0.01U
nsa
tisf
acto
ry
FK
BI
(%)
P <0.001R
este
nos
is (
%)
P =0.001M
AC
E (
%)
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.
THANKS