药物洗脱支架和金属裸支架治疗冠状动脉小血管病变的疗效

Effect of Drug-Eluting Stent and Bare Metal Stent in Small Coronary Arterial Lesions

目的评估雷帕霉素洗脱支架(SES)治疗小管径冠状动脉内粥样硬化病变的疗效。方法回顾性分析448例小血管病变SES植入病人和124例裸金属支架(BMS)植入病人的长期疗效。统计并比较住院期间及9个月不良心血管事件发生率(MACE)。结果SES组治疗复杂病变更多,平均支架长度更长,9个月后再狭窄率明显低于BMS组(1.6%vs9.9%,P<0.001);MACE发生率也显著低于BMS组(4.3%vs13.90%;P<0.001)。结论与BMS组相比,在小血管复杂病变中植入SES是有效的,能明显减少术后9个月再狭窄和靶病变血运重建率。

Objective To compare the acute and long-term outcomes of patients treated with Sirolimus-eluting stents（SES） and those implanted with bare-metal stents（BMS） in small coronary arteries at a high volume cardiac center. Methods We retrospectively compared consecutive 448 patients who underwent SES implantation in small coronary arteries and 124 patients who received conventional BMS. The SES and the BMS placements were available in diameters of 2.25, 2.5, and 2.75 mm. In-hospital and 9-month follow-up of major adverse cardiac events（MACE） were evaluated. Results Compared with the BMS group, implanted SES had larger mean diameter and length. 9-month follow-up showed that the angiographic restenosis rate was significantly lower in the SES group than those of the BMS group（1.60 vs 9.90%, P〈0. 001）. The overall rate of MACE was 4.30% in the SES group and 13.9% in the BMS group （P〈0.001）. Conclusion Compared with BMS, SES implantation in small coronary arteries is effective and associated with a marked reduction in restenosis rate and the need for subsequent target lesion revascularization at nine months.