直接冠状动脉内支架术在急性冠状动脉综合征中的应用

Application of direct coronary stenting to treat acute coronary syndromes

目的 探讨急性冠状动脉综合征 (ACS)患者直接冠状动脉支架术治疗的可行性和安全性。方法 选择 ACS患者 6 8例 ,依据冠状动脉造影的结果采取直接支架术。用定量冠状动脉造影分析支架术前和术后即刻的造影结果 ,并随访观察术后近期临床疗效。结果 直接支架置入术成功率为 94 .1%。其中不稳定型心绞痛者成功率为96 .0 % ,急性心肌梗死成功率 88.9%。支架术后血管狭窄程度较术前明显减轻。慢复流的发生率为 7.8%。未发生与介入操作相关的严重并发症。术后近期随访无严重心血管事件发生。结论 对经选择的 ACS患者采取直接支架术治疗成功率高 ,并发症低 。

Objective To evaluate the feasibility and the safety of direct coronary stenting in the patients of acute coronary syndrome (ACS). Methods According to the angiogram, 68 cases of solected patients of ACS received direct coronary stenting. Highly calcified, excessive proximal tortuosity, and total occluded lesion can not be identified after across the guide wire were excluded. Quantitative coronary angiography was performed before and immediately after the procedure. Serious complications and major cardiac events were recorded during hospitalization and one-month follow-up. Results The successful procedure was achieved in 64 (94.1%) of 68 cases. The success rate was 96.0% in unstable angina patients, and 88.9% in acute myocardial infarction. The degree of stenosis was decreased significantly compared with stenting before, with 7.8% cases presenting slow-flow after stenting. There were no serious complications and major cardiac events during follow-up. Conclusion Direct coronary senting can be safely performed in selected patients of acute coronary syndromes with low complications and better clinical effect in shortterm.