冠状动脉支架植入术治疗不稳定性心绞痛

Coronary-stent implantation in treatment of unstable angina pectoris of 28 patients

目的探讨不稳定性心绞痛患者行冠状动脉支架植入术的疗效和安全性。方法对28例不稳定性心绞痛患者病变部位38处施行冠状动脉内支架植入术,植入支架37枚。结果支架植入成功36枚,成功率97.3%,血管直径由术前0.45±0.28mm增至术后3.32±0.31mm(P<0.001),血管狭窄程度由术前的(92.5±5.2)%降至(-5.0±8.5)%(P<0.001),冠脉血流达到TIMI3级。随防7.6±4.5月,大多数患者心绞痛症状消失,心电图缺血情况改善,均无急性和亚急性支架内血栓发生,3例4～6个月后出现心绞痛。结论冠状动脉内支架植入术成功率高,安全性较好,但左冠脉主干病变支架植入应从严掌握,CABG可能是更好的选择。

Objective To summarize the preliminary clinical experience of intracoronary-stent implanta-tion and to evaluate the clinical efficiency and safety.Methods From June,2001to February,2003,the28patients suffering from unstable angina pectoris were treated with angiography to illuminate the features of lesions and proceeded with PTCA plus stenting.Results A total of37stents were implanted in28patients(male25,female3),32vessles and38lesions(including2left main artery).Five lesions(13.2%)were type A,nineteen lesions(50.0%)were type B and fourteen lesions(36.8%)were type C,intracoronary-stent implantation success rate was97.3%;vessel eliameter,(0.45±0.28)mm increased to(3.31±0.31)mm(P<0.01)after the procedure.There were no major complication.After follow up,3patients had recurrence of angina with in half a year,1patient with left main artery disease died later fifth month after the procedure.Conclusion PTCA plus stenting are effective and safe to treat patients with unstable angina pectoris.For left main artery disease,CABG perhaps is a better selection.