带膜支架对老年冠状动脉介入治疗术中冠状动脉穿孔患者的疗效

Efficiency of covered stent on elderly patients with coronary perforation during percutaneous coronary intervention

目的评价带膜支架治疗经皮冠状动脉介入治疗（PCI）术中发生冠状动脉穿孔老年患者的疗效。方法从2004年6月至2011年6月，本中心共对8例PCI术中发生冠状动脉穿孔后植入带膜支架的老年患者进行了1年随访，观察其主要心脏不良事件（MACE）发生率。结果8例患者中男4例，女4例，年龄65±76岁，平均（70．4±4．1）岁。植入带膜支架直径平均（3．2±O．3）mm，长度平均（21．0±3．4）mm，所有患者破口均被成功封闭，术中无死亡病例。随访1年，1例急性前壁心肌梗死患者术后19天因肺部感染导致多器官功能衰竭而死亡，其余患者均无心绞痛发作。随访期间死亡率为12．5％（1／8），MACE发生率为12．5％（1／8）。结论带膜支架治疗老年冠状动脉穿孔能达到较好的近期和远期疗效。

Objective To evaluate the efficiency of covered stent implantation on the elderly patients with coronary perforation occurred in percutaneous coronary intervention （PCI）. Methods From June 2004 to June 2011, 8 cases having coronary perforation during PCI received covered stents implantation. They were followed up for 1 year for the occurrence of major adverse cardiac events （MACE）. Results There were 4 males and 4 females with an age ranging from 65 to 76 years mean （70.4 ± 4.1） years. Average diameter of implanted covered stents was （3.2± 0.3）mm, and average length was （21.0 ±3.4）mm. In all patients, perforation was successfully closed, while no patient died in the procedure. One patient with acute anterior myocardial wall infarction died of multiple organ failure due to lung infection at day 19 after PCI. No patient had angina pectoris during 1 year follow-up. Both of mortality and MACE rate were 12.5% （1/8） in 1 year after PCI. Conclusion Treatment of covered stent in elderly patients with coronary perforation can achieve good efficacy.