冠状动脉分叉病变不同介入治疗方法的临床应用及研究进展
Clinical Application and Research Progress of Different Interventional Treatment Methods for Coronary Bifurcation Lesions
DOI: 10.12677/ACM.2024.143737, PDF,   
作者: 温晓林, 蒋 叶:新疆医科大学研究生学院,新疆 乌鲁木齐;赖红梅*:新疆维吾尔自治区人民医院,心血管内科,新疆 乌鲁木齐
关键词: 冠状动脉疾病冠状动脉分叉病变经皮冠状动脉介入治疗Coronary Artery Disease Coronary Artery Bifurcation Disease Percutaneous Coronary Intervention
摘要: 冠状动脉分叉病变占所有经皮冠状动脉介入治疗的15%~20%,是冠心病介入治疗中较难处理的一种复杂病变类型,且由于冠脉分叉病变个体差异极大、手术操作复杂、术中风险高、术后并发症多等特点,术者难以一套标准流程解决所有分叉病变。因此,明晰患者分叉病变的分型及术式选择对于临床治疗具有重要意义。本文就冠状动脉分叉病变介入治疗研究进展作一综述。
Abstract: Coronary bifurcation lesions account for 15%~20% of all percutaneous coronary interventional treatments, and are a complex lesion type that is difficult to be managed in coronary interventional therapy. Due to the characteristics of great individual differences in coronary bifurcation lesions, complicated surgical operations, high intraoperative risks, and multiple postoperative complica-tions, it is difficult for surgeons to solve all bifurcation lesions with a standard procedure. Therefore, it is of great significance for clinical treatment to clarify the classification of patients with bifurcated lesions and the selection of surgical methods. This article reviews the progress of interventional therapy for coronary bifurcation disease.
文章引用:温晓林, 蒋叶, 赖红梅. 冠状动脉分叉病变不同介入治疗方法的临床应用及研究进展[J]. 临床医学进展, 2024, 14(3): 547-554. https://doi.org/10.12677/ACM.2024.143737

参考文献

[1] Amsterdam, E.A., Wenger, N.K., Brindis, R.G., et al. (2014) 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 130, e344-e426.
[2] Lassen, J.F., Albiero, R., Johnson, T.W., et al. (2022) Treatment of Coronary Bifurcation Lesions, Part II: Implanting Two Stents. The 16th Expert Consen-sus Document of the European Bifurcation Club. Eurointervention, 18, 457-470. [Google Scholar] [CrossRef
[3] Starodumov, I.O., Sokolov, S.Y., Alexandrov, D.V., et al. (2022) Modelling of Hemodynamics in Bifurcation Lesions of Coronary Arteries before and after Myocardial Revascularization. Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences, 380, Article ID: 20200303. [Google Scholar] [CrossRef] [PubMed]
[4] He, L., Zhang, C.L., Chen, Q., et al. (2022) Endothelial Shear Stress Signal Transduction and Atherogenesis: From Mechanisms to Therapeutics. Pharmacology & Therapeutics, 235, Article ID: 108152. [Google Scholar] [CrossRef] [PubMed]
[5] Yamamoto, E., Siasos, G., Zaromytidou, M., et al. (2017) Low Endothelial Shear Stress Predicts Evolution to High-Risk Coronary Plaque Phenotype in the Future: A Serial Opti-cal Coherence Tomography and Computational Fluid Dynamics Study. Circulation: Cardiovascular Interventions, 10, e005455. [Google Scholar] [CrossRef
[6] Kelsey, L.J., Bellinge, J.W., Majeed, K., et al. (2021) Low Endothelial Shear Stress Is Associated with High-Risk Coronary Plaque Features and Microcalcification Ac-tivity. JACC: Cardiovascular Imaging, 14, 2262-2264. [Google Scholar] [CrossRef] [PubMed]
[7] Wojtasińska, A., Frąk, W., Lisińska, W., et al. (2023) Novel In-sights into the Molecular Mechanisms of Atherosclerosis. International Journal of Molecular Sciences, 24, Article No. 13434. [Google Scholar] [CrossRef] [PubMed]
[8] Ludwig, J., Mohamed, M. and Mamas, M.A. (2021) Left Main Bifurcation Lesions: Medina Reclassification Revisited—As Easy as ABC. Catheterization and Cardiovascular Inter-ventions, 97, 186-187. [Google Scholar] [CrossRef] [PubMed]
[9] Riley, R.F., Henry, T.D., Mahmud, E., et al. (2020) SCAI Position State-ment on Optimal Percutaneous Coronary Interventional Therapy for Complex Coronary Artery Disease. Catheterization and Cardiovascular Interventions, 96, 346-362. [Google Scholar] [CrossRef] [PubMed]
[10] Li, Y., Li, Z., Holck, E.N., et al. (2018) Local Flow Patterns after Implantation of Bioresorbable Vascular Scaffold in Coronary Bifurcations-Novel Findings by Computational Fluid Dynamics. Circulation Journal, 82, 1575-1583. [Google Scholar] [CrossRef
[11] Shen, C., Gharleghi, R., Li, D.D., et al. (2021) Secondary Flow in Bifurcations—Important Effects of Curvature, Bifurcation Angle and Stents. Journal of Biomechanics, 129, Article ID: 110755. [Google Scholar] [CrossRef] [PubMed]
[12] Radunović, A., Vidaković, R., Timčić, S., et al. (2023) Mul-tislice Computerized Tomography Coronary Angiography Can Be a Comparable Tool to Intravascular Ultrasound in Evaluating “True” Coronary Artery Bifurcations. Frontiers in Cardiovascular Medicine, 10, Article ID: 1292517. [Google Scholar] [CrossRef] [PubMed]
[13] Banning, A.P., Lassen, J.F., Burzotta, F., et al. (2019) Percuta-neous Coronary Intervention for Obstructive Bifurcation Lesions: The 14th Consensus Document from the European Bi-furcation Club. Eurointervention, 15, 90-98. [Google Scholar] [CrossRef
[14] Ge, Z., Gao, X.F., Zhan, J.J., et al. (2022) Coronary Bifurcation Le-sions. Interventional Cardiology Clinics, 11, 405-417. [Google Scholar] [CrossRef] [PubMed]
[15] Lee, D.H., Oh, S., Kim, M.C., et al. (2023) Comparative Treatment Outcomes of a Single Long Stent vs. Overlapped Short Stents in Acute Myocardial Infarction. Frontiers in Cardiovascular Medicine, 10, Article ID: 1284396. [Google Scholar] [CrossRef] [PubMed]
[16] Azzalini, L., Moroni, F. and Santiago, R. (2022) Subintimal Shift at the Bifurcation: A Cause of Side Branch Occlusion in Chronic Total Occlusion Intervention. Cardiovascular Revascu-larization Medicine, 40, 298-301. [Google Scholar] [CrossRef] [PubMed]
[17] Nasir, M., Shafique, H.M., Hussain, S., et al. (2020) Percutane-ous Coronary Intervention for Left Main Coronary Artery Bifurcation Lesions: Two-Stent versus One-Stent Strategy for Comparison of 6-Month MACE. JCPSP-Journal of College of Physicians and Surgeons Pakistan, 30, 894-899. [Google Scholar] [CrossRef] [PubMed]
[18] Choi, K.H., Bruno, F., Cho, Y.K., et al. (2023) Comparison of Outcomes between 1- and 2-Stent Techniques for Medina Classification 0.0.1 Coronary Bifurcation Lesions. JACC: Cardiovascular Interventions, 16, 2083-2093. [Google Scholar] [CrossRef] [PubMed]
[19] Arunothayaraj, S., Behan, M.W., Lefèvre, T., et al. (2023) Stepwise Provisional versus Systematic Culotte for Stenting of True Coronary Bifurcation Lesions: Five-Year Follow-Up of the Multicentre Randomised EBC Two Trial. Eurointervention, 19, E297-E304. [Google Scholar] [CrossRef
[20] Meng, S., Kong, X., Nan, J., et al. (2023) Comparing the Clinical Outcomes of Single vs. Systematic Dual Stenting Strategies for Unprotected Left Main Bifurcation Lesion: A Systematic Review and Meta-Analysis. Frontiers in Cardiovascular Medicine, 10, Article ID: 1145412. [Google Scholar] [CrossRef] [PubMed]
[21] Burzotta, F., Lassen, J.F., Louvard, Y., et al. (2020) European Bifurcation Club White Paper on Stenting Techniques for Patients with Bifurcated Coronary Artery Lesions. Catheteriza-tion and Cardiovascular Interventions, 96, 1067-1079. [Google Scholar] [CrossRef] [PubMed]
[22] Zhang, Q., Huan, H.S., Han, Y., et al. (2022) Clinical Outcomes Following Simple or Complex Stenting for Coronary Bifurcation Lesions: A Meta-Analysis. Clinical Medicine Insights: Cardiology, 16. [Google Scholar] [CrossRef] [PubMed]
[23] Guo, Y., Peng, H., Zhao, Y., et al. (2021) Predictors and Com-plications of Side Branch Occlusion after Recanalization of Chronic Total Occlusions Complicated with Bifurcation Le-sions. Scientific Reports, 11, Article No. 4460. [Google Scholar] [CrossRef] [PubMed]
[24] Qin, Q., Zheng, B., Liu, J., et al. (2021) Active versus Conven-tional Side Branch Protection Strategy for Coronary Bifurcation Lesions. International Heart Journal, 62, 1241-1248. [Google Scholar] [CrossRef] [PubMed]
[25] Shen, H., Yang, L.X., Wang, Z.J., et al. (2019) Efficacy and Safety of Ac-tive Transfer of Plaque versus Provisional Stenting with Drug-Eluting Stents for the Treatment of Coronary Bifurcation Lesions. Chinese Journal of Cardiovascular Diseases, 47, 549-553.
[26] Zhang, D., Zhao, Z., Gao, G., et al. (2022) Jailed Balloon Technique Is Superior to Jailed Wire Technique in Reducing the Rate of Side Branch Occlusion: Subgroup Analysis of the Conventional versus Intentional Strategy in Patients with High Risk Prediction of Side Branch Occlusion in Coronary Bifurcation Intervention Trial. Frontiers in Cardiovascular Medicine, 9, Article ID: 814873. [Google Scholar] [CrossRef] [PubMed]
[27] Hidalgo, F., González-Manzanares, R., Ojeda, S., et al. (2023) Jailed Pressure Wire Technique for Coronary Bifurcation Lesions: Structural Damage and Clinical Outcomes. Revista Española de Cardiología (Engl Ed), 76, 531-538. [Google Scholar] [CrossRef
[28] Khan, B.K., Rahman, M.N., Tai, J.M., et al. (2020) Jailed Bal-loons for Side Branch Protection: A Review of Techniques and Literature: Jailed Balloons for Side Branch Protection. AsiaIntervention, 6, 15-24. [Google Scholar] [CrossRef
[29] Shishido, K., Moriyama, N., Hayashi, T., et al. (2020) The Efficacy of Modified Jailed Balloon Technique for True Bifurcation Lesions. Catheterization and Cardiovascular Interventions, 96, 20-28. [Google Scholar] [CrossRef] [PubMed]
[30] Pellegrini, D., Ielasi, A., Tespili, M., et al. (2023) Percutaneous Treatment of Left Main Disease: A Review of Current Status. Journal of Clinical Medicine, 12, Article No. 4972. [Google Scholar] [CrossRef] [PubMed]
[31] Wang, R., Ding, Y., Yang, J., et al. (2022) Stenting Techniques for Coronary Bifurcation Disease: A Systematic Review and Network Meta-Analysis Demonstrates Superiority of Dou-ble-Kissing Crush in Complex Lesions. Clinical Research in Cardiology, 111, 761-775. [Google Scholar] [CrossRef] [PubMed]
[32] Zhang, J.J., Ye, F., Xu, K., et al. (2020) Multicentre, Random-ized Comparison of Two-Stent and Provisional Stenting Techniques in Patients with Complex Coronary Bifurcation Le-sions: The DEFINITION II Trial. European Heart Journal, 41, 2523-2536. [Google Scholar] [CrossRef] [PubMed]
[33] Gaede, L. (2022) Bifurcation Lesions: Are New Strategies and De-vices Needed? Herz, 47, 485-494. [Google Scholar] [CrossRef] [PubMed]
[34] Chen, X., Li, X., Zhang, J.J., et al. (2019) 3-Year Outcomes of the DKCRUSH-V Trial Comparing DK Crush with Provisional Stenting for Left Main Bifurcation Lesions. JACC: Car-diovascular Interventions, 12, 1927-1937. [Google Scholar] [CrossRef] [PubMed]
[35] Chevalier, B., Mamas, M.A., Hovasse, T., et al. (2021) Clinical Outcomes of the Proximal Optimisation Technique (POT) in Bifurcation Stenting. Eurointervention, 17, e910-e918. [Google Scholar] [CrossRef
[36] Dérimay, F., Aminian, A., Lattuca, B., et al. (2024) One Year Results of Coronary Bifurcation Revascularization with the Re-POT Provisional Sequential Technique. The CABRIOLET Regis-try. International Journal of Cardiology, 397, Article ID: 131632. [Google Scholar] [CrossRef] [PubMed]
[37] Watanabe, Y., Murasato, Y., Yamawaki, M., et al. (2021) Prox-imal Optimisation Technique versus Final Kissing Balloon Inflation in Coronary Bifurcation Lesions: The Randomised, Multicentre PROPOT Trial. Eurointervention, 17, 747-756. [Google Scholar] [CrossRef
[38] Yerasi, C., Case, B.C., Forrestal, B.J., et al. (2020) Drug-Coated Balloon for De Novo Coronary Artery Disease: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 75, 1061-1073. [Google Scholar] [CrossRef] [PubMed]
[39] Rissanen, T.T., Uskela, S., Eränen, J., et al. (2019) Drug-Coated Balloon for Treatment of De-Novo Coronary Artery Lesions in Patients with High Bleeding Risk (DEBUT): A Sin-gle-Blind, Randomised, Non-Inferiority Trial. The Lancet, 394, 230-239. [Google Scholar] [CrossRef
[40] Li, Y., Mao, Q., Liu, H., et al. (2022) Effect of Paclitax-el-Coated Balloon Angioplasty on Side Branch Lesion and Cardiovascular Outcomes in Patients with De Novo True Coronary Bifurcation Lesions Undergoing Percutaneous Coronary Intervention. Cardiovascular Drugs and Therapy, 36, 859-866. [Google Scholar] [CrossRef] [PubMed]
[41] Dash, D., Mody, R., Ahmed, N., et al. (2022) Drug-Coated Balloon in the Treatment of Coronary Bifurcation Lesions: A Hope or Hype? Indian Heart Journal, 74, 450-457. [Google Scholar] [CrossRef] [PubMed]
[42] Liang, H.B., Guo, Q., Zhang, X.L., et al. (2017) Clinical Outcomes of Intravascular Ultrasound in Guiding the Treatment of Non-Left Main Intermediate Coronary Lesions for Patients with Acute Coronary Syndrome. Journal of Southern Medical University, 37, 707-711.
[43] Chen, L., Xu, T., Xue, X.J., et al. (2018) Intravascular Ultrasound-Guided Drug-Eluting Stent Implantation Is Associated with Improved Clinical Outcomes in Patients with Unstable Angina and Complex Coronary Artery True Bifurcation Lesions. The Inter-national Journal of Cardiovascular Imaging, 34, 1685-1696. [Google Scholar] [CrossRef] [PubMed]
[44] Ramasamy, A., Chen, Y., Zanchin, T., et al. (2020) Optical Co-herence Tomography Enables More Accurate Detection of Functionally Significant Intermediate Non-Left Main Coronary Artery Stenoses than Intravascular Ultrasound: A Meta-Analysis of 6919 Patients and 7537 Lesions. International Journal of Cardiology, 301, 226-234. [Google Scholar] [CrossRef] [PubMed]