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首页> 外文期刊>Journal of the American College of Cardiology >Predictors and outcomes of side branch occlusion after main vessel stenting in coronary bifurcation lesions: Results from the COBIS II registry (coronary bifurcation stenting)
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Predictors and outcomes of side branch occlusion after main vessel stenting in coronary bifurcation lesions: Results from the COBIS II registry (coronary bifurcation stenting)

机译：主动脉支架置入术对冠状动脉分叉病变后侧支闭塞的预测和结果：COBIS II登记簿（冠状动脉分叉支架置入）的结果

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Objectives This study sought to investigate the predictors and outcomes of side branch (SB) occlusion after main vessel (MV) stenting in coronary bifurcation lesions. Background SB occlusion is a serious complication that occurs during percutaneous coronary intervention (PCI) for bifurcation lesions. Methods Consecutive patients undergoing PCI using drug-eluting stents for bifurcation lesions with SB ≥2.3 mm were enrolled. We selected patients treated with the 1-stent technique or MV stenting first strategy. SB occlusion after MV stenting was defined as Thrombolysis in Myocardial Infarction flow grade <3. Results SB occlusion occurred in 187 (8.4%) of 2,227 bifurcation lesions. In multivariate analysis, independent predictors of SB occlusion were pre-procedural percent diameter stenosis of the SB ≥50% (odds ratio [OR]: 2.34; 95% confidence interval [CI]: 1.59 to 3.43; p < 0.001) and the proximal MV ≥50% (OR: 2.34; 95% CI: 1.57 to 3.50; p < 0.001), SB lesion length (OR: 1.03; 95% CI: 1.003 to 1.06; p = 0.03), and acute coronary syndrome (OR: 1.53; 95% CI: 1.06 to 2.19; p = 0.02). Of 187 occluded SBs, flow was restored spontaneously in 26 (13.9%) and by SB intervention in 103 (55.1%) but not in 58 (31.0%). Jailed wire in the SB was associated with flow recovery (74.8% vs. 57.8%, p = 0.02). Cardiac death or myocardial infarction occurred more frequently in patients with SB occlusion than in those without SB occlusion (adjusted hazard ratio: 2.34; 95% CI: 1.15 to 4.77; p = 0.02). Conclusions Angiographic findings of SB, proximal MV stenosis, and clinical presentation are predictive of SB occlusion after MV stenting. Occlusion of sizable SB is associated with adverse clinical outcomes. (Korean Coronary Bifurcation Stenting Registry II [COBIS]; NCT01642992).
机译：目的本研究旨在探讨冠状动脉分叉病变中主血管（MV）置入支架后侧支（SB）闭塞的预测因素和结果。背景SB闭塞是严重的并发症，发生在分叉病变的经皮冠状动脉介入治疗（PCI）期间。方法连续入选行药物洗脱支架行SB≥2.3 mm分叉病变的PCI患者。我们选择采用1支架技术或MV支架置入术优先治疗的患者。 MV支架置入术后SB闭塞定义为心肌梗死血流<3级的溶栓。结果SB闭塞发生在2,227个分叉病变中的187个（8.4％）。在多变量分析中，SB阻塞的独立预测因素是SB≥50％的术前直径狭窄百分比（优势比[OR]：2.34; 95％置信区间[CI]：1.59至3.43; p <0.001）和近端MV≥50％（OR：2.34; 95％CI：1.57至3.50; p <0.001），SB病变长度（OR：1.03; 95％CI：1.003至1.06; p = 0.03）和急性冠脉综合征（OR： 1.53; 95％CI：1.06至2.19; p = 0.02）。在187个阻塞的SB中，有26个（13.9％）自发恢复血流，通过SB干预有103个（55.1％）自发恢复血流，而58个（31.0％）没有恢复。 SB中的铁丝网与流量恢复相关（74.8％对57.8％，p = 0.02）。 SB闭塞患者的心源性死亡或心肌梗塞的发生率比无SB闭塞的患者更高（调整后的危险比：2.34; 95％CI：1.15至4.77; p = 0.02）。结论SB的血管造影检查结果，近端MV狭窄和临床表现可预测MV支架置入后SB的闭塞。大量SB的闭塞与不良的临床结果有关。 （韩国冠状动脉分叉支架注册系统II [COBIS]; NCT01642992）。

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