背景和目的:冠状动脉口部病变的经皮冠状动脉介入(PCI)治疗手术操作难度大,易有并发症,既要支架准确植入口部病变,又要边支不受压.本研究探讨解决这一难题的Szabo技术的成功率、安全性和可行性.方法:Szabo技术是利用边支导丝(抛锚导丝)穿过支架最靠近边支的支架网眼,防止支架前进时停止在口部病变外,保证主支导丝穿过支架腔.作者回顾性分析利用Szabo 技术治疗39例病人冠状动脉口部病变的结果.手术操作成功定义:支架没有脱落,边支导丝没有退出.造影成功定义:支架准确植入到口部,而边支没有受压.血管内超声定义成功:支架准确植入到口部,近段没有突出,支架完全覆盖病变.39例病人中,男性28 例,女性11例,年龄43～79,平均(65±12)岁.6F 和7F 指引导管分别用于35例 (89.7%) 和 4 (10.3%) 例病人.经桡动脉途径31 (79.5%) 例和经股动脉途径8 (20.5%)例.病变相关血管:前降支 (LAD) 26 (66.7%)例,右冠(RCA) 5 (12.8%)例,旋支及钝缘支 (LCX-OM) 3 (7.7%)例,后降支(PDA) 5 (12.8%)例.支架植入后30 (76.9%) 例病变相关血管和9 (23.1%) 例边支血管经过了血管内超声(IVUS)检查.结果:手术操作成功:36 例 (92.3%),这36 例造影均成功(100%).IVUS 检测:支架准确植入口部者96.7% (29例/30例),支架近段轻度凸出的只有1 例(3.3%).没有发生严重并发症.结论:结果说明 Szabo技术用于冠状动脉口部病变PCI成功率很高,是安全和可行的,值得推广.“,”Objective:Background Percutaneous coronary intervention (PCI) on ostial lesions in coronary arteries associated with higher procedural difficulty and complication morbility. It has been technically difficult because it should be done with precise stent placement in ostium and absence of side branch compromise. The Szabo technique consists of side branch wiring through most proximal stent strut as well as main branch wiring through stent lumen. The side branch wire or anchor wire prevents stent advancement beyond ostial segment and makes possible the accurate stent implantation in ostium. The purpose of this study is to evaluate the safety, feasibility and success rate of Szabo technique by analysing technical, angiographic and IVUS (Intravascular Ultrasonography) findings.Methods:The data of 39 PCIs in 39 patients with a significant lesion at a coronary artery ostium which was treated percutaneously using Szabo technique were retrospectively analysed. The technically successful procedure was defined as there was neither stent loss nor second guide wire pull back during stent advancement. A successful procedure from angiographic point of view was defined as a precise stent implantation at ostium without side branch compromise. Successful procedure from IVUS point of view was defined as accurate stent placement in ostium without proximal protrusion and without any stent uncovered area. A total of 39 patients was with 28 males and 11 females. They aged from 43 to 79 years with a mean age of (65±12)years. The 6F and 7F guiding catheter were used in 35 (89.7%) and 4 (10.3%) patients separately. The access was radial in 31 (79.5%) and femoral in 8 (20.5%) patients. The culprit vessel was left anterior descending (LAD) in 26(66.7%), right coronary artery (RCA) 5 (12.8%), circumflex-obtuse marginal (LCX-OM) 3(7.7%), and posterior descending (PDA) 5(12.8%). IVUS was performed through culprit vessel in 30 (76.9%) and was also done in side branch in 9 (23.1%) patients after stent implantation.Results:The procedure was technically successful in 36 (92.3%) patients. All technically successful patients had angiographic success (100%). IVUS examination of culprit vessel showed accurate stent placement in ostium 29 (96.7%) and slight stent proximal protrusion in 1(3.3%) patients. No serious complication occured. Conclusion:This study shows that Szabo technique is safe and feasible for PCI in ostial coronary artery lesions with a high angiographic success rate,its deserved to spread.