Khảo sát đặc điểm tổn thương thân chung động mạch vành trái trên siêu âm nội mạch ở bệnh nhân bệnh động mạch vành mạn tính được can thiệp

Abstract

Objective: To survey the characteristics of left main (LM) coronary artery in chronic coronary artery disease patients who had IVUS-guided intervention. Subject and method: A cross-sectional descriptive study of chronic coronary artery disease patients had IVUS-guided left main intervention at Bach Mai Hospital from April 2017 to October 2019. Result: 55 patients (male 61.8%, mean age 68.9 ± 1.1), 45.5% had PCI. On angiography: Ostium/trunk/distal lesions were 18.2%/3.6%/78.2% respectively, mean stenosis rate 45.7 ± 14.9%, 29.1% LM stenosis > 50%, 70.9% intermediate LM disease. On IVUS: MLA ≤ 6mm² ostium 18.2%, at trunk 12.7%, distal 78.2%, plaque burden > 50% at all of sites, mix, calcified atheroma, intermediate remodeling was mostly. Compared with angiography, IVUS reduced diagnosis of proximal LAD stenosis (from 94.5% to 90.4%), LCx stenosis (from 36.4% to 21.8%), bifurcation lesion from 36.4% to 21.8% significantly. Conclusion: With 29.1% left main stenosis > 50%, 70.9% intermediate left main disease on angiography, IVUS regarded MLA ≤ 6mm², plaque burden > 50%. Compared with angiography, IVUS reduced the diagnosis of proximal LAD stenosis, LCx stenosis, thereby reducing the diagnosis of bifurcation lesions significantly.