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首页> 外文期刊>Circulation journal >Clinical and angiographic outcomes with sirolimus-eluting stent for coronary bifurcation lesions. The J-PMS study.
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Clinical and angiographic outcomes with sirolimus-eluting stent for coronary bifurcation lesions. The J-PMS study.

机译：西罗莫司洗脱支架治疗冠状动脉分叉病变的临床和血管造影结果。 J-PMS研究。

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BACKGROUND: Long-term outcomes of patients with bifurcated lesions and the restenotic response of the side branches after sirolimus-eluting stent (SES) implantation, comparing 1-stent with 2-stent treatment, are still under discussion. METHODS AND RESULTS: Japan Post-Marketing Surveillance Registry (J-PMS) is a prospective registry designed to evaluate the safety and efficacy of the SES in routine clinical practice. Angiograms of 1,063 patients with 1,250 lesions were analyzed at the independent core lab. Of these, 324 patients with bifurcation lesions were enrolled. Clinical endpoints were assessed at 3 years. Both main and side branches were evaluated by quantitative coronary angiography at post-procedure (n=349) and 8-month follow up (n=293). Two-stent treatment was performed in 12% of the cases. In-segment restenosis rates at 8 months were 25.6% in the side branch, but newly developed restenosis was seen in only 6.8%. Late loss at the carina of the side branch was -0.11mm in the 1-stent group. Major adverse cardiovascular events rate was 18.3% at 3 years. Target-lesion revascularization rate up to 3 years was 21.6% in the 2-stent group and 8.7% in the 1-stent group (P=0.037). Stent thrombosis occurred in 6 cases (2.0%) until 3 years. Of these, 4 cases were treated with 2-stent (10.81% vs. 0.76% in 1-stent, P=0.003, respectively). CONCLUSIONS: In a real-world setting, treatment of coronary bifurcation lesions using SES demonstrated favorable long-term outcomes as long as the side branch was not stented.
机译：背景：西罗莫司洗脱支架（SES）植入后，分叉病变患者的长期预后和侧支再狭窄反应（将1支架与2支架治疗进行比较）仍在讨论中。方法和结果：日本上市后监视注册表（J-PMS）是一个前瞻性注册表，旨在评估SES在常规临床实践中的安全性和有效性。在独立的核心实验室分析了1,063名有1,250个病变的患者的血管造影照片。其中招募了324例分叉病变患者。在3年时评估临床终点。在手术后（n = 349）和8个月的随访（n = 293）中通过定量冠状动脉造影术评估主干和侧支。在12％的病例中进行了两支架治疗。侧支8个月的节段内再狭窄率为25.6％，但新近发生的再狭窄仅6.8％。 1个支架组中，侧支的隆突迟发损失为-0.11mm。 3年时的主要不良心血管事件发生率为18.3％。 2支架组至3年的靶病变血运重建率分别为21.6％和1支架组8.7％（P = 0.037）。直到3年为止，有6例（2.0％）发生了支架血栓形成。其中4例接受2支架治疗（1支架分别为10.81％和0.76％，P = 0.003）。结论：在现实世界中，只要不安装侧支，使用SES治疗冠状动脉分叉病变均显示出良好的长期疗效。

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