Excel支架和Cypher支架治疗弥漫病变的对比研究

Comparison of Excel Stents and Cypher Stents for Treating the Patients With Diffuse Coronary Lesions

目的:评价弥漫冠状动脉病变置入Excel支架(长度=36 mm)和Cypher支架(长度=33 mm)的安全性和有效性。方法:研究对象为2010-01至2011-12我院的316例置入Excel支架(长度=36 mm,Excel支架组)和315例Cypher支架(长度=33 mm,Cypher支架组)的冠心病患者,比较置入两种支架的患者临床特征、操作特点及主要不良心脏事件(包括死亡、心肌梗死和靶病变血运重建)。结果:在病变特点方面,与Cypher支架组相比,Excel支架组右冠状动脉病变(P<0.001)、近段血管极度扭曲病变(P<0.05)、病变成角>45°(P<0.01)比例较高,左前降支病变(P<0.001)、分叉病变(P<0.05)比例较低。在操作特点方面,Excel支架组支架总长度、平均支架数明显高于Cypher支架组(P<0.001)。操作成功率和血管径路并发症发生率差异无统计学意义(P>0.05)。两组12个月主要不良心脏事件发生率、心肌梗死的发生率、死亡率靶病变血运重建率差异无统计学意义(P>0.05)。结论:与Cypher支架(长度=33 mm)相比,弥漫长病变植入Excel支架(长度=36 mm)临床疗效类似,但极度扭曲病变、成角>45°病变置入长Excel支架更多见。

Objective： To compare the safety, efficacy of Excel stents and Cypher stents in treating the patients with diffuse coronary lesions. Methods： We retrospectively studied 631 patients with diffuse coronary lesions who were treated in our hospital from January 2010 to December 2011by implanting Excel stents （length=36mm） as Excel group, n=316, and Cypher stents （length=33mm） as Cypher group, n=315. We compared the clinical and procedural characteristics and the major adverse cardiac events （MACE） including death, myocardial infarction （MI） and target lesion revascularization （TLR） between 2 groups. Results： For lesion characteristics, compared with Cypher group, the Excel group had obviously increased right coronary lesion, P〈0.001, severe tortuous lesion in proximal vessels, P〈0.05, angular lesion〉45 degree, P〈0.01 and significantly decreased left anterior descending lesion, P〈0.001, bifurcation lesion, P〈0.05. For procedural characteristics, the Excel group had longer total stent＇s length and more number of stents, P〈0.001. There were no real differences for procedural success rate, vascular complication rate, and no real differences of MACE between 2 groups, P〉0.05 respectively. Conclusion： Our work indicated that both Excel stents （length=36mm） and Cypher stents （length=33mm） had similar effect for diffuse long coronary lesions in clinical practice, while Excel stent implantation were more used for severe tortuous lesion and angular lesion 〉45 degree.