国产雷帕霉素药物洗脱支架在冠状动脉分叉病变介入治疗中的应用

The application of domestic produced drug-eluting stent(FirebirdTM) in patients with bifurcation coronary lesions treated by primary percutaneous coronary intervention

目的探讨国产雷帕霉素药物洗脱支架[DE(SFirebirdTM)]在冠状动脉分叉病变介入治疗中应用的安全性和有效性。方法对47例冠心病患者的53处冠状动脉分叉病变行介入治疗,共置入FirebirdTM68枚。结果46例介入治疗成功,失败1例。分叉病变部位:左主干远端前降支和回旋支分叉病变2处,前降支和对角支分叉病变23处,回旋支和钝缘支分叉病变17处,左心室后侧支和后降支11处。术中发生边支血管闭塞4例,边支血管狭窄加重6例,边支血管发生慢血流3例。住院期间发生急性非ST段抬高型心肌梗死3例,ST段抬高型心肌梗死1例,心绞痛5例,1例于术后2天死于心源性休克。随访6个月,7例复发心绞痛而再次住院治疗,无其余主要不良心脏事件发生。结论DE(SFirebirdTM)在冠状动脉分叉病变介入治疗中应用是可行、安全有效的。

Objective To investigate the feasibility, safety and efficacy of domestic produced drug luting stent （FirebirdTM）implanting in patients with bifurcation coronary artery lesions treated by percutaneons coronary intervention （PCI）. Methods 47 patients with coronary artery disease were treated by PCI in their bifurcation coronary lesions. Results 68 domestic produced dmg-eluting stents （FirebirdTM）were successfully implanted on 53 bifurcation lesions and 1 lesion failed. 2 bifurcation lesions related to left anterior descending artery and left circumflex artery. 23 bifurcation lesions were in left anterior descending artery and diagonal branch artery. 17 bifurcation lesions were in left circumflex and obtuse marginal branch position and 11 bifurcation lesions located left posterior lateral artery and left posterior descending artery. 4 cases had side-branch occlusion and 6 had accelerated stenosis and 3 had slow-flow in side-branch lesions during operation. There wear 3 acute non-ST-elevation myocardial infarction and 1 acute ST-elevation myocardial infarction and 5 recurrent angina in the period of in-hospital. 1 patient dead of cardiogenic shock afar 2 days of the procerdure . 7 patients had re-hospitalized because of recurrence of angina during 1-6 month follow-up periods. Implanting domestic produced drug-eluting stent （FirebirdTM） in patients with bifurcation coronary lesions treated by primary PCI was as safe and effective as that d conventional bare metallic stent.