血管内支架在冠状动脉复杂病变成形术中的临床应用

Clinical application of coronary stent for complex coronary lesions

目的 探讨血管内支架在冠状动脉复杂病变成形术中的应用效果及价值。方法 对冠心病患者复杂冠状动脉病变在经皮穿刺冠状动脉成形术 (PTCA)并发急性血管内闭塞、内膜严重撕裂、术后显著残留狭窄及短期内再狭窄等情况下进行了血管内支架植入术 (CASI)。结果 31例患者CASI均获成功 ,术后急性血管闭塞和内膜撕裂征象消失 ,残留狭窄及再狭窄解除 ,未出现出血和穿刺部位血管并发症及CASI后亚急性血栓形成。随访 16例 ,1例术后 13天发生猝死 ;2例因胸痛复发经造影证实支架血管再狭窄 ,再次球囊扩张后再狭窄改善 ;余 13例冠状动脉造影示支架血管正常。结论 冠心病复杂冠状动脉病变行CASI是解除PTCA急性并发症的安全、有效和可行的方法 ,并有助于PTCA后再狭窄的防治。

Objective To evaluate the clinical results of intracoronary implantation of stents in coronary heart disease patients with complex coronary lesions.Methods 42 steel stents were implanted into coronary artery of 31 patients;Results All stents were implanted successfully with uneventful sequence and few complication.The acute occlusion and dissection disappeared,while the residual stenoses and restenoses were reduced signifcantly after stent implantation.No other stent-subacute thrombosis or severe bleeding were observed in hospital stay.Restenosis was found in 2 cases and one sudden death occurred 13 days after stenting within 16 cases during follow-ups.Conclusion It is suggested that intracoronary stenting is a safe and efficient interventional procedure for prevention and treatment of acute complications following PCTA,and can reduce the formation of coronary restenosis as well.