完全闭塞与非闭塞冠状动脉病变支架植入术的比较

COMPARISON OF CLINICAL AND ANGIOGRAPHIC OUTCOMES OF STENTING FOR TOTALLY OCCLUDED VERSUS NONOCCLUDED CORONARY ARTERY LESIONS

目的 :比较完全闭塞与非闭塞冠状动脉病变支架植入术的临床及冠状动脉造影效果。方法 :对 2 10例患者共 2 93处病变行冠状动脉支架植入术 ,患者分为完全闭塞组 (6 4例 ,6 9处病变 )和非闭塞组 (14 6例 ,2 2 4处病变 ) ,观察两组患者的临床及冠状动脉造影效果。结果 :血管最小腔径 :术前闭塞组显著小于非闭塞组 (P <0 .0 0 1) ,而术后则两组没有统计学差异 (P >0 .0 5 ) ;围手术期并发症 :影像并发症闭塞组显著高于非闭塞组(18.7%vs 6 .8% ,P <0 .0 1) ,但临床并发症两组无显著性差异 (7.8%vs.5 .5 % ,P >0 .0 5 ) ;再狭窄及再闭塞 :再狭窄发生率在闭塞组为 2 9.2 % ,非闭塞组 2 4 .8% ,再闭塞则分别为 8.3%和 5 .7% ,两组比较均无显著性差异 (P >0 .0 5 ) ;临床终点事件 :闭塞组 2 8.6 % ,非闭塞组 2 5 .2 % ,两组比较无显著性差异 (P >0 .0 5 )。结论 :完全闭塞与非闭塞冠状动脉病变支架植入术具有相近的临床及冠状动脉造影效果。

Objective:To compare the clinical and angiographic outcomes of coronary stenting for total occlusions with nonocclusive stenoses.Methods:A total of 210 consecutive patients (293 lesions) underwent coronary stenting. The study population was divided into total occlusion group (64 patients with 69 lesions) and non-occlusion group (146 patients with 224 lesions). The immediate and long-term clinical and angiographic outcomes were evaluated.Result:The postprocedure minimum lumen diameter was (3.14±0.52) mm in the total occlusion group and (3.16±0.53) mm in the non-occlusion group ( P >0.05). There was no difference in incidence of clinical complications between the two groups (7.8% vs. 5.5%, P >0.05).A total of 29.2% of patients in the total occlusion group and 24.8% of patients in the non-occlusion group occurred restenosis ( P > 0.05). Clinical endpoint events occurred in 28.6% of patients in the total occlusion group compared with 25.2% in the non-occlusion group ( P > 0.05). Conclusion: The clinical and angiographic outcomes of coronary stenting for total occlusions are similar to that for nonocclusive stenoses.