药物洗脱支架和普通支架导致直径小于2.5mm分支血管闭塞的对比研究

Comparative study of <2.5mm in diameter side branch closure after drug eluting stent and bare stent implantation

目的 观察冠状动脉药物洗脱支架植入对直径小于 2 .5mm分支血管的影响。方法 记录冠心病危险因子和冠状动脉病变特征 ,对比分析药物洗脱支架和普通支架植入对直径小于 2 .5mm分支血管的影响 ,并观察患者手术前后血清C反应蛋白和肌钙蛋白变化。结果 6 4 8例患者 783处病变共植入支架 917枚 ,累及直径小于 2 .5mm分支血管 12 5 6支 ,其中药物支架组 5 84例 ,普通支架组 6 72例。与普通支架组比较 ,药物支架组植入支架较长 ,但两组支架植入后分支闭塞发生率相似。进一步分析支架植入血管狭窄≥ 90 %、分支血管开口处≥ 5 0 %狭窄 82 6支分支血管 ,发现药物支架组 (n =36 9)较普通支架组 (n =4 5 7)支架植入后分支闭塞发生率较高 (4 8例和 4 5例 ) ,但差异无显著性。结论 药物洗脱支架较普通支架植入易导致直径小于 2 .5mm分支血管闭塞 。

Objective To assess <2.5mm in diameter side branch closure after drug eluting stent implantation.Methods Coronary risk factors and characteristics of coronary artery lesion were documented. Respective analysis of <2.5 mm in diameter side branch closure after drug eluting stent and bare stent implantation. The change of C reactive protein and tropnin T were also collected before and after stent implantation. Results Among 789 lesion in 648 patients, there were 1256 side branches <2.5 mm in diameter which involved after stent implantation. Compared with bare stent group (n=672) the drug eluting stent group (n=584) had similar side branches closure rate, but had more side branches closure in subgroup with ≥90% stenosis in the main vessel and ≥50% narrowing in the orifice of side branch although not meet significant difference.Conclusions The side branches <2.5 mm in diameter possibly had more closures after drug eluting stent implantation compared with bare stent implantation.