| Objective: To compare the immediate imaging effect of three different protection techniques and without side branch protection on the true bifurcation lesions of coronary artery.Methods: This study is a retrospective study and selected patients with true coronary artery bifurcation lesions(1,1,1 lesions in Medina classification)who received PCI in the Department of Cardiology,Liaoning Provincial People’s Hospital from September2018 to September 2020 A total of 258 cases.And on the basis of the characteristics of the bifurcated disease,an experienced cardiologist made the decision with the informed consent of the family members to have a Treasure wire technique to protect the skin and a Treasure balloon 4 groups: the JBT(without Balloon dilatation)(42),the Balloonstent Kissing Technique(BSKT)(52),or the Balloon-stent Kissing Technique(83).Collection of four groups of patient’s age,gender,BMI,creatinine,preoperative hemoglobin,myocardial enzyme,total cholesterol,low-density lipoprotein cholesterol(ldl-c),ejection fraction,smoking history,history of hypertension,diabetes and other related clinical data and pathological changes of coronary blood vessels,preoperative main and side vascular lesion characteristics,preoperative main and side opening degree of stenosis,The incidence of intraoperative immediate lateral branch occlusion,postoperative residual stenosis of the lateral branch and TIMI blood flow restriction were compared in 4 groups.Results: A total of 258 patients were enrolled in the four groups,and there were differences between the groups in terms of general clinical data,bifurcation angle of the lesion,the distribution of blood vessels in the lesion,the degree of stenosis of the proximal,distal and side branches of the main branch and the degree of residual stenosis.No statistical significance(P>0.05).In the four selected groups of patients,the immediate occlusion rate of the diseased branch,the restricted blood flow of the diseased branch,and the degree of branch stenosis were severely affected,P<0.05,indicating that there are significant differences between the four groups.Among them,the JWT group was compared with the group without side branch protection,in the three results of the immediate occlusion rate of the diseased branch,the restricted blood flow of the diseased branch(TIMI blood flow classification <3),and the degree of branch stenosis,P<0.05,indicating There was statistical significance between the JWT group and the side branch protection group.Comparison of JBT group with no side branch protection group,JBT group with JWT group,three results are severely affected in the immediate occlusion rate of the diseased branch,the blood flow limitation of the diseased branch(TIMI blood flow grade <3),and the degree of branch stenosis The upper P<0.05 indicates that there is statistical significance between the JWT group and the unprotected side branch group and the JBT group.Comparing the BSKT group with the side branch protection group,the JWT group,and the JBT group respectively,there are 3 results that the immediate occlusion rate of the diseased branch,the blood flow restriction of the diseased branch(TIMI blood flow grade <3),and the degree of branch stenosis are severely affected.Above,the comparison between the BSKT group and the non-side branch protection group and the JWT group was P<0.05,indicating that the BSKT group and the non-side branch protection group and the JWT group were also statistically significant.However,when comparing the clinical endpoints of the BSKT group and the JBT group,it can be found that the two groups have P>0.05 in the two results of the immediate occlusion rate of the diseased branch and the restricted blood flow of the diseased branch(TIMI blood flow classification<3).In the two results,the difference between the BSKT group and the JBT group was not statistically significant,and when the degree of branch stenosis was severely affected,it was also found that P<0.05,indicating that the BSKT group and the JBT group are statistically significant.Conclusion: In the interventional treatment of coronary atherosclerotic true bifurcation lesions(1,1,1 lesions in Medina classification),the clinical effect of protecting the side branches is worthy of recognition,and can reduce the immediate occlusion rate.And the occurrence of branch blood flow restriction events.And compared with other side branch protection strategies,the balloon stent kiss technique can further reduce the occurrence of immediate occlusion rate,branch blood flow limitation and postoperative side branch vessel stenosis.However,due to the lack of follow-up and other limitations in this clinical study,the results still need more and larger clinical data and random experiments to confirm. |
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