摘要
目的评价雷帕霉素洗脱支架(商品名Cypher支架,强生公司产品)治疗支架内再狭窄的疗效及安全性。方法27例支架内再狭窄且有临床缺血症状的患者接受了Cypher支架治疗,其中23例患者的支架内再狭窄为弥漫、复杂病变,有5例同时置入了2个Cypher支架。术后对所有患者进行临床随访及冠状动脉造影复查。结果所有支架均成功置入,无残余狭窄或残余狭窄<10%,未见任何并发症。平均随访时间8.9±2.1(5~14)年,临床随访率96.3%,造影随访率92.6%。随访期间,无一例患者死亡。有1例支架近端边缘节段血管发生了再狭窄导致临床心绞痛复发,2例支架近端边缘节段有轻微的新生内膜增殖,但狭窄程度<25%,其余24例均无明显的晚期管腔丢失。本组支架内平均晚期管腔丢失(0.09±0.02)mm、支架远端边缘节段(0.10±0.03)mm、支架近端边缘节段(0.20±0.06)mm。靶血管血运重建率3.8%。结论Cypher支架治疗支架内再狭窄安全、可行,它能有效防止这类病变的新生内膜增殖和再次再狭窄。
ObjectiveTo evaluate the effectiveness and safety of sirolimus-eluting stents (SESs) for treatment of in-stent restenosis (ISR). MethodsAll 27 patients with ISR and clinical evidence of ischemia had been treated with SESs. Among them, 23 patients had diffuse and complex lesions, and 5 of them received 2 SESs. Clinical and angiographic follow-up were performed for all patients and the results were analyzed. Results All stents were implanted successfully. There were no remained stenosis and major in-hospital complications. Average follow-up time was 8.9±2.1(5-14)months, with a clinical follow-up rate of 96.3% and angiographic follow-up rate of 92.6%. During the follow-up, there was none of death. One patient had recurrent angina with an angiographic evidence of the proximal edge restenosis of the stent . Mild neointimal hyperplasia in the proximal edge was found in 2 patients, but the stenosis was less than 25%. No late lumen loss was found in other 24 patients. The late lumen loss of the in-stent averaged 0.09±0.02 mm, and of the distal edge vessel averaged 0.10±0.03 mm,and of the proximal edge vessel averaged 0.20±0.06 mm. The rate of target vessel revascularization was 3.8%. Conclusion The SES implantation is safe and feasible for the treatment of in-stent restenosis, which could effectively prevent neointimal hyperplasia and recurrent restenosis of the lesion.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2005年第5期441-443,共3页
Chinese Journal of Cardiology