AMI直接冠状动脉内支架置入术20例临床分析

Observation of direct stenting without balloon predilation in 20 patients with AMI

目的:分析急性心肌梗塞(AMI)病人无球囊预扩张而直接冠脉内置入支架的疗效。方法:对20例起病时间12h内,急诊冠脉造影评价可行直接冠脉内支架置入术的患者,行直接支架置入术,术后即刻冠脉造影评价,并观察住院期间和3个月内的冠脉临床事件。结果:20例患者梗塞相关动脉(IRA)20支,置入支架20枚,即刻支架成功率100％。支架置入后血流均达TI-MIⅢ级,残余狭窄<30％,住院期间无一例死亡及急性和亚急性支架内血栓。结论:急性直接冠脉内支架置入术治疗AMI,手术成功率高,并发症少,住院及近期临床效果好,是治疗AMI安全可靠的方法。

Objective:The study assess the safety,feasibility and efficacy of direct stenting without balloon predilation in acute myo-cardial infarction( AMI) . Methods :The present study collected 38 patients with AMI, of whom 20 cases received direct stenting without balloon predilation within 12 hours after the heart attack started. Coronary angiography was obtained immediately both before and after stenting in order to assess the status of treated vessele. All patients were followed up for 3 months from in to out of hospital, Adverse cardiac events were studied at end point. Results; The angiographic characteristics of the lesions were found in 20 infarct -related arteries(IRA) ,Then 20 stents were respectively implanted without balloon predilation ( 100% success rate) , and the final residual diametter stenosis poststenting was < 30%. All stented coronary arteries achived TIMI grade 3 flow. Neither the acute and subacute occlusion nor adverse cardiac events occurred during follow - up period. Conclusion: Use of direct stenting in AMI was feasible and safe, had the merit of less complications and higher efficacy.