| Objective:The study was to to explore the value of clinical application of jailed balloon technique by comparison of the immediate and short-term clinical efficacy of jailed balloon technique and traditional side branch protection technique on the protection of side branch artery in coronary artery true bifurcation lesions.Methods:71 patients with coronary angiography coronary bifurcation lesions and receiving PCI in the hospital The Second Affiliated Hospital of Kunming Medical University from March 2013 to October 2014 were divided into two groups group A(to protect side branch with jailed balloon,28 cases)、group B (traditional side branch protection group,43 cases) to compare intraoperative and postoperative complications, operative time, irradiation dose, the amount of guide wire and balloon, consumption of contrast agent, operation costs and other indicators of all patients. Meanwhile, an average six months (6.24 ± 0.43 months) follow-up of a total of 51 patients in both groups were done to observe the incidence of cardiovascular event in patients and explore the immediate and short-term clinical efficacy of jailed balloon side branch protection technology in protection of branch vessel in bifurcation lesions.Results:1. There were no significant difference between gender (t=0.25, P=1.000), ages(t=1.59, P=0.116), smoking (t=0.31, P=0.579), alcohol (t=0.13, P=0.723), body weight index (t=0.41, P=0.684),preoperative use of anticoagulants (Fisher= 0.308, P=0.857), coronary artery lesions (Fisher=3.524, P=0.388), the degree of side branch opening stenosis (t=3.18, P=0.502) and other indicators among both groups, coupled with comparable equality.2. Comparison of intraoperative complications:Patients in group A, there were not slow flow and occlusion in the side branch, one patient Appeared thatthe side branch increased due to the Implant of the main branch stent, and need to exchange the guide wire between main branch and side branch and the guide wire was exchanged successfully. In group B, there were 5 cases of slow flow in side branch occurred in patients of group B (with the incidence of 11.63%).,2 cases of stenosis aggravated in side branch (with the incidence is 4.65%),1 case happened of side-branch occlusion (the incidence is 2.33%).3. Comparison of postoperative cardiovascular events and review results of angiography:there were 51 patients following doctor’s orders after surgery and with doing regular follow-up and review of coronary angiography, including 19 cases of group A and 32 cases of group B. Among the 19 patients of group A with postoperative follow-up, one case of angina pectoris occurred. No signs of angina, sudden cardiac death and other incidents could be found in other patients, and no reduced ejection fraction could be found by cardiac ultrasound, additionally, no slow flow in target blood vessel of TIMI and opening branch vessel restenosis could be found by the review of coronary angiography; among 32 cases of group B with postoperative follow-up, two cases of angina (with incidence of 6.25%) occurred, and one case of side branch opening restenosis (with incidence of 3.13%) could be found by angiography review, without no other adverse events.4. Comparison of related indicators of PCI:(1) the amounts of balloon:the average number of group A was 1.04 ± 0.19, and the average numbert of group B was 1.37 ± 0.76 (t=-2.78, P=0.008); (2) operative time:the average amount of group A was 56.43±11.29 min, the average amount of group B was 83.53±27.53min (t=-5.76,P<0.001); (3) the amount of irradiation dose:group A with a median amount of radiation 4878.5mSv, group B with a median amount of radiation 7756.0mSv, The difference was statistically significant (Z=5.55,P<0.001); (4) the number of guide wire:group A was 2.00 ± 0.00, group B was 2.34 ± 0.58 (t=-3.55,P=0.001); (6) operation costs:the average amount of group A was 2.79±0.53 ten thousand yuan, the average amount of group B was 3.86±1.14 ten thousand yuan (t=-5.31, P<0.001); (7) contrast agent:the average amount of group A was 123.39 ± 13.27ml, the average amount of group B was 146.05 ± 43.14ml (t=-3.22, P=0.002).Conclusions:The application of jailed balloon technique in ture bifurcation lesions can reduce the incidence of cardiovascular events after PCI, operative time, exposure dose of intraoperative X-ray received by doctors and patients, the surgical consumables and related medical expenses of patients. |
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