小型猪冠脉支架模型中即刻OCT检查评价支架贴壁不良的安全性和有效性

Stent Malapposition Immediately after Stent Implantation:A Study from Optical Coherence Tomography Examination on Mini Pig Model

目的评价中华小型猪冠状动脉支架植入术后即刻行光学相干断层成像扫描(OCT)的安全性和有效性。方法健康中华小型猪22只,经股动脉途径行右冠状动脉西罗莫司药物洗脱支架植入术,术后即刻行OCT检查评价支架贴壁不良情况,同时记录OCT检查时间和相关并发症。结果 OCT共检查25段支架,失败3例(1例指引导丝断裂于支架内,2例发生冠脉痉挛导致阻断球囊送入困难未能成像),OCT检查并发症包括一过性ST段抬高(5例)和室颤(3例),死亡1例,平均手术时间49.7±12.9 min,其中OCT检查耗时17.9±4.9 min,OCT共检测522 mm支架,定量测量4514个支架丝,其中66个存在贴壁不良,即刻支架贴壁不良率1.46%。结论利用冠脉内OCT技术可以有效评价支架术后即刻贴壁不良情况,安全性良好。

Objective To investigate the safety and efficacy of immediately coronary optical coherence tomography（OCT） examination after stent implantation in the mini pig model.Methods Twenty-two health Chinese mini pigs were given percutaneous coronary stent implantation in right coronary artery.Stent strut malapposition was evaluated by OCT analysis.The duration and complication of OCT examination were recorded at the same time.Results OCT examination was performed on 25 stents and failed in 3 cases（1 pig had guiding wire fractured inside stent and 2 had coronary artery spasm and failed to deliver the occlusion balloon）.Side effect contained 5 cases of temporarily ST segment elevation and 3 cases of ventricular fibrillation（2 pigs survived after successful electrical defibrillation and 1 dead）.The mean duration of operation and OCT examination was 49.7±12.9 minutes and 17.9±4.9 minutes respectively.OCT detected 4514 stent struts and discovered 66 malapposition struts.And the rate of malapposition strut immediately after stent implantation was 1.46%.Conclusion OCT examination could be applied on mini pig stent implantation model with high quality and safety and was effective enough to evaluate the strut malapposition immediately after stent implantation.