冠脉介入术后再发血栓的机制及相关防治

Mechanism and related prevention and treatment of recurrence of thrombus after coronary intervention

经皮冠状动脉介入治疗(PCI)的发展为急性冠脉综合征(ACS)患者带来前所未有的曙光,但支架内血栓的形成仍是医疗技术发展所要攻克的难题。支架内血栓形成是一种罕见的冠状动脉介入治疗的并发症,并与随后的不良事件有关。从早期的单纯球囊扩张到药物涂层支架技术的不断改进,支架内血栓的发生率显著降低。同时,针对患者既往病史及个体化风险评估、抗凝及抗血小板药物的应用、对冠脉内早期血栓识别技术的发展、冠脉支架的选择及血栓抽吸术的应用都是减少支架内血栓发生的重要环节。现从冠脉介入术后支架内血栓形成的诱因、机制及相关防治进行概述。

The development of percutaneous coronary intervention(PCI)has brought unprecedented wish to patients with acute coronary syndrome(ACS),but the stent thrombosis is still a difficult problem to be overcome in the development of medical technology.Stent thrombosis is a rare complication of coronary intervention and is related to subsequent adverse events.From the early simple balloon expansion to the continuous improvement of drug-coated stent technology,the incidence of stent thrombosis has been markedly reduced.Meanwhile,assessment on patient′s past medical history and individualized risk,the application of anticoagulant and antiplatelet drugs,the development of early coronary thrombus recognition technology,the selection of coronary stents,and the application of thrombus aspiration serve as important parts for stent thrombosis reduction.This article summarized the causes,mechanisms and related prevention and treatment of stent thrombosis after coronary intervention.