雷帕霉素药物洗脱支架的临床应用研究

Clinical Study of the Use of Rapamycin Eluting Etent

目的 :探讨雷帕霉素药物洗脱支架的使用方法、安全性及近期临床效果。方法 :共对52例冠心病患者进行介入治疗。术后随访1～6个月观察有无心绞痛、心肌梗死、猝死及再次血管重建事件。结果 :靶病变参照血管直径 (2.96±0.13)mm ,平均狭窄 (84.9±10.2) % ,平均长度 (22.6±7.2)mm。长病变32例 (52 % ) ,小血管病变7例(11 % )。支架置入时 ,选用短球囊、长支架 ,支架完全覆盖病变 ,以12～16标准大气压充分扩张 ,再扩张时避免损伤支架两端血管内膜。手术即刻成功率100 % ,TIMI血流3级 ,病变残余狭窄<10 %。临床随访1～6个月无心绞痛、心肌梗死、猝死及血管重建事件。结论 :使用雷帕霉素药物洗脱支架具有良好的安全性及满意的近期效果 。

Objective:To investigate the implantation technique of rapamycin eluting stent and to evaluate its clinical effect and safety in treatment of patients.Methods:The study enrolled52patients with coronary heart disease including14diatetes patients.All patients were followed up for1～6months for major adverse cardiac events such as angina pectoris,myocardial infarction,sudden death and target lesion revascularization.Results:Target vessel diameter(2.96±0.13)mm,mean stenosis(84.9±10.2)%,mean lesion length(22.6±7.2)mm.The lesions including32(52%)longer lesions and7(11%)small vessels lesions were treated with rapamycin eˉluting stent.When rapamycin eluting stent were implanted,shorter balloon and longer stent were used in order to cover entire lesion and high pressure of12～16atmospheres were reached to assure entirely dilation.If redilation was necessary,keeping orginal site in order to avoid injury of stent margin.The success rate of stent implantation were100%.TIMI flow of grade3.The lesion resulteel resiodual stenosis<10%.The clinical folˉlow-up for1～6months showed no major adverse cardiac events(angina pectoris,myocardial infarction,sudden death and revascularization).Conclusion:The treatment of implanting rapamycin eluting stent is of safety and good clinical effect,but needs some special technique of implantation.