摘要
目的:观察在同一患者中置入的西罗莫司药物洗脱支架和裸金属支架(BMS),评估置入即刻和6个月随访时的生理学参数:血流储备分数(FFR)、充血时跨支架压力阶差(HTG)和管壁切应力(WSS)。方法与结果:共纳入20例至少有2支冠状动脉需行经皮冠状动脉介入治疗的患者,其冠状动脉的血管和狭窄特征具有可比性,随机置入1枚西罗莫司洗脱支架和1枚BMS。置入即刻和6个月随访时测定冠状动脉压力、FFR、HTG和WSS。
Aims: The aim of this study was to investigate the physiologic parameters: fractional flow reserve (FFR), hyperaemic trans-stent gradient (HTG), and wall shear stress(WSS) at implantation and at 6-month follow-up in the drug-eluting sirolimus stent and in its bare metal counterpart implanted in pairs within the same patient. Methods and results: Twenty patients, accepted for percutaneous coronary intervention of at least two coronary arteries with comparable vessel and stenosis characteristics, received at random one sirolimus-eluting stent and one bare metal stent(BMS). Coronary pressure, FFR, HTG, and WSS were measured just after stent implantation and at 6-month fo-llow-up. At 6-month follow-up, FFR was significantly higher in the sirolimus group compared with the bare metal group(0.91±0.05 vs. 0.83±0.10, P=0.027) and HTG was significantly lower (1.2±1.2 vs. 7.5±8.1mmHg, P< 0.001). In-stent WSS at 6 months remained normal in the sirolimus group but was elevated in the bare metal group (1.6±0.7 vs 3.9±3.1 Pa, respectively, P=0.003). Conclusion: The physiologic characteristics of the drug-eluting sirolimus stents were superior to those of the equivalent BMS. Six months after implantation, FFR was significantly higher, HTG was significantly lower in arteries treated by a sirolimus stent, and normal WSS was maintained within the drug-eluting stent.
