国产西罗莫司药物洗脱支架治疗冠脉支架内再狭窄疗效观察

Therapeutic effects on homemade sirolimus drug-eluting stent in treatment of in-stent restenosis

目的：初步评价国产西罗莫司药物洗脱支架治疗支架内再狭窄的安全性和有效性。方法：32例支架内再狭窄且有临床缺血症状的冠心病患者接受了国产西罗莫司药物洗脱支架治疗，共置人支架34个，术后临床随访6个月，部分患者进行冠造复查。结果：全部支架均成功置入，术中和住院期间未发生任何并发症。平均随访3—15（8．6．±2．2）个月，临床随访率93．8％（30／32），造影随访率78．1％（25／32）。随访期间，1例术后第3个月行冠脉造影示支架内完全闭塞，考虑为迟发型血栓形成，行冠状动脉旁路移植术后第3天死亡，余冠脉造影无支架内再狭窄。主要不良心脏事件发生率3．3％（1／30），支架内血栓发生率3．3％（1／30），再次再狭窄率3．3％（1／30）。结论：国产西罗莫司药物洗脱支架治疗冠脉支架内再狭窄病变安全、有效，能有效预防、治疗再狭窄。

Objective：To evaluate the efficiency and safety of homemade sirolimus drug-eluting stent in treatment of instent restenosis （ISR） in patients with coronary artery disease. Methods：All 32 patients with ISR and clinical evidence of iscbemia had been treated with Firebird stents. Follow-up was done by interview. A proportion of patients were followed up by angiography. Results：All stents were implanted successfully. There were no major complications during the procedure and hospital. Average follow up time was 3-15 months （8.6±2.2）, with a clinical follow-up rate of 93.8% and angiographic follow-up rate of 78.1%. One patient had recurrent angina with an angiographic evidence of the complete occlusion in stent after procedure three months. The possible cause of complete occlusion was the formation of late thrombosis. The patient was death in the third day after the bypass surgery. The major adverse cardiac event （ including death, acute myocardial infarction and target lesion revascularization, MACE） rate, the stent thrombosis rate and the restenosis rate of stent was all 3.3 % （1/30）. Conclusion：The homemade sirolimus drug-eluting stent implantation is safe and feasible for the treatment of in-stent restenosis in patient with coronary heart disease.