冠状动脉内支架植入术在冠心病治疗中的应用

Coronary┐stentimplantationinthetreatmentofcoronaryarterydisease

报道６８例冠心病患者８０支血管病变植入１１８个支架，植入成功率为９２．１％。其中不稳定心绞痛者占５０％，既往有心肌梗塞史者占４６％，多支病变者占６２．４％，Ｂ２型以上病变占６６．６％，因ＰＴＣＡ术后不良结果而植入支架的病变占２７．５％（２２／８０），因术后急性并发症者１７．５％（１４／８０），Ｄｅｎｏｖｏ病变占５５％（４４／８０）。狭窄程度由术前的８５．５％±１２．９％减至术后的５．８％±１１．４％。术后４周～１年间，６０例患者（８８．２％）症状缓解，６例（８．８％）心绞痛复发，其中４例（５．８％）经冠状动脉造影证实支架部位再狭窄，术后２个月内死亡２例（２．９％）。

Background:Coronarystentsareimplantedforbetterresultspost-PTCA,especialyfordenovolesions.118stentsimplantationin3yearswereinvestigatedforevaluatingtheclinicaloutcomes.Methods:StentswereimplantedafterconventionalPTCA,orpredilationof4-8atm.Di-ameterstenosesweremeasuredbyQCA.Patientsweregroupedinto3withdifferentanticoagulantregimensperi-procedure.Clinicalresultswererecordedduring1year.Results:118coronarystentswereimplantedinto80vesselsof68patients.Fifty-percentpatientshadunstableanginapectoris,while46%hadpriormyocardialinfarction.Ofthelesions,62.4%weremultiple-vessel,66.6%B2andC-type.42stentswereinto26RCA,58in48LAD,9in6LCX.22stentswereforsuboptimalresultsofPTCA,14foracuteaccidentand44fordenovolesions.Stenoseswereimprovedfrom85.5%+12.9%to5.8%+11.4%.Twopatientsdied.Onehadnon-QwaveMIwhile62patientsre-mainedasymptomaticand4patientswerefoundrestenosis.Nosignificantstatisticaldifferenceofclinicalresultswereshowedamong3groups.Conclusions:CoronarystentsimplantationissafeandefficacyforthecomplexlesionsofCADpatients,includingforsuboptimalresultsandacutephasespost-PTCA.Complicationswereacceptable.