Intravascular Ultrasound Play A Guiding Role In The Interventional Treatment Of Unprotected Left Main Coronary Artery Lesion

Objective:Explore intravascular ultrasound (IVUS) to unprotected left main coronaryartery disease (ULMCA) drug-eluting stents (DES) interventional treatment forguidance and the influence of for prognosis,Explore IVUS evaluation DESplacement effect.Methods:Select from December2010to2011in the Department of Cardiology ofthe Second Clinical Hospital of Jilin University hospital clear isolated ULMCAlesions in the coronary angiography (CAG) or IVUS examination, and accordwith left main coronary artery disease intervention stents indication,andsuccessfully received DES (drug-eluting stent, DES) placement of the patientsof54,CAG and IVUS examination of21patients before and after DESimplantation, that is,the application of IVUS guidance,the Group A,33patientsintraoperative not application IVUS instruction, the group B. Compare two setsof stents diameter and postoperative6months follow-up results.21cases ofapplication in patients with IVUS steering group IVUS examination after DESplacement, lesion does not meet IVUS ideal stent placement standards to givehigh-pressure balloon post-dilatation, do IVUS examination showed the lesionshave reached the IVUS ideal stent standard. More application IVUS evaluationof expansion and application before balloon IVUS evaluation of the expansionof the balloon expansion after the balloon diameter,expansion pressure,expansion balloon number.Results:（1） Gender,age,history of hypertension,history of diabetes, hyperlipidemia,smoking history between the application of IVUS guidancegroup and not application of IVUS guidance group differences were notstatistically significant (P>0.05).（2） IVUS guidance group stent diameter was3.67±0.48mm,notapplication of IVUS guidance group stent diameter was3.40±0.53mm,thedifference was not statistically significant (P>0.05). But the application ofIVUS guidance group stent diameter is greater than the application of IVUSguidance group.（3）15lesions with IVUS evaluation before and after the expansion of theballoon pressure was12.53±3.42atm,16.07±2.82atm,the difference wasstatistically significant (p <0.05).15lesions with IVUS evaluation before andafter the expansion of balloon diameter was3.63±0.57mm,3.70±0.40mm, thedifference was not statistically significant (P>0.05).15lesions with IVUSevaluation before and after expansion balloon times were1.27±0.46,1.53±1.03,the difference was not statistically significant (P>0.05).（4）DES implantation application of IVUS guidance in patients6monthsafter recurrence of angina in3cases (14.29%),no application of IVUS guidancegroup,14cases (42.42%), the difference was statistically significant (P <0.05).The two groups in restenosis, recurrent myocardial infarction, TLR, again, thePCI, CABG, death and total MACE events were not statistically significant (P>0.05).Conclusion:In ULMCA lesions in IVUS application do DES placement, to help selectthe appropriate stent. Real-time evaluation of stent expansion and adherentsituation so as to achieve the best of stents effect, so as to reduce the occurrenceof cardiovascular events, improve the prognosis of patients.