Objective To study the clinical value of coronary stenting in treatment of severe complex coronary artery lesions, to evaluate the short and long term outcome of the patients imployed coronary stents, and to well reco...Objective To study the clinical value of coronary stenting in treatment of severe complex coronary artery lesions, to evaluate the short and long term outcome of the patients imployed coronary stents, and to well recognize the role of stenting in dealing with the complications of PTCA.Methods In this study, two hundrad sixty four patients with coronary artery disease were included, who were classified as PTCA group (138 cases)and coronary stented group(126 cases).They all received Exercise Test(ET)、Ultrasound Cardiogram(UCG)and Ambulatory Electrocardiography (AECG)at admission and before discharge, respectively. The coronary artery lesions were categorized into type A.B.C according to the methods reported by ACC/AHA . It was that the data between two groups including clinical information, cronary artery lesion characteristicis, procedural success rate, major complications, Minimum Lumen Diameter (MLD),residual stenosis, collateral circulation scores both before and after procedure had been compared. Following up were performed 6 months to 3 years after procedure. Results The study showed that there were no significant different in two groups including the clinical information, positive rate of ET, EF, results of AECG. But the rate of type B2/C lesions were higher in CS group than that in PTCA group( P <0.05). Both PTCA Group and CS Group had extremely success rate in type A and type B1, but CS had a higher success rate than that in PTCA in type B2 and type C (94.28%VS 89.2%, P <0.05). CS group had a lower rate of complication in procedure than that of PTCA group. There are no signifiance in MLD between the two groups (0.53± 0.22)mm vs (0.42±0.26)mm,( P >0.05) before procedure. But MLD was signifantly higher in CS group than that in PTCA group (2.51±0.66)mm vs (3.08±0.66)mm,( P <0.001) after procedure.The collateral circulation scrores were signifantly decreased after procedure (1.7±0.6) vs (0.8±0.4); (2.1±0.3) vs (0.3±0.4) in both PTCA Group and PTCA Group respectivesly,( P <0.001). Residual stenosis were higher in PTCA group(15±6%)than that in CS group (6±3%, P <0.001). The positive rate of ET, exercise capacity, ST depressions, EF and wall motion were all improved significantly both in PTCA group and CS group, CS group has a higher effect in exercise capacity, MLD, EF and ischemia duration.Seventy nine patients were followed up and the rate of cardiac events in the CS group were lower than in PTCA group.Conclusions 1.Coronary stenting had a high success rate and low complication in treatment of severe and complex coronary artery lesions.2.Coronary stentig reduced residual stenosis, improved blood supply, salvaged the hibernating and /or stunned myocardium, improved the left ventricular function. CS have offered a new, safe and effective metbods for treatment of left main trunk lesions; 3.Coronary stenting has broden the indication for invasive treatment of coronary artery diseases.展开更多
文摘Objective To study the clinical value of coronary stenting in treatment of severe complex coronary artery lesions, to evaluate the short and long term outcome of the patients imployed coronary stents, and to well recognize the role of stenting in dealing with the complications of PTCA.Methods In this study, two hundrad sixty four patients with coronary artery disease were included, who were classified as PTCA group (138 cases)and coronary stented group(126 cases).They all received Exercise Test(ET)、Ultrasound Cardiogram(UCG)and Ambulatory Electrocardiography (AECG)at admission and before discharge, respectively. The coronary artery lesions were categorized into type A.B.C according to the methods reported by ACC/AHA . It was that the data between two groups including clinical information, cronary artery lesion characteristicis, procedural success rate, major complications, Minimum Lumen Diameter (MLD),residual stenosis, collateral circulation scores both before and after procedure had been compared. Following up were performed 6 months to 3 years after procedure. Results The study showed that there were no significant different in two groups including the clinical information, positive rate of ET, EF, results of AECG. But the rate of type B2/C lesions were higher in CS group than that in PTCA group( P <0.05). Both PTCA Group and CS Group had extremely success rate in type A and type B1, but CS had a higher success rate than that in PTCA in type B2 and type C (94.28%VS 89.2%, P <0.05). CS group had a lower rate of complication in procedure than that of PTCA group. There are no signifiance in MLD between the two groups (0.53± 0.22)mm vs (0.42±0.26)mm,( P >0.05) before procedure. But MLD was signifantly higher in CS group than that in PTCA group (2.51±0.66)mm vs (3.08±0.66)mm,( P <0.001) after procedure.The collateral circulation scrores were signifantly decreased after procedure (1.7±0.6) vs (0.8±0.4); (2.1±0.3) vs (0.3±0.4) in both PTCA Group and PTCA Group respectivesly,( P <0.001). Residual stenosis were higher in PTCA group(15±6%)than that in CS group (6±3%, P <0.001). The positive rate of ET, exercise capacity, ST depressions, EF and wall motion were all improved significantly both in PTCA group and CS group, CS group has a higher effect in exercise capacity, MLD, EF and ischemia duration.Seventy nine patients were followed up and the rate of cardiac events in the CS group were lower than in PTCA group.Conclusions 1.Coronary stenting had a high success rate and low complication in treatment of severe and complex coronary artery lesions.2.Coronary stentig reduced residual stenosis, improved blood supply, salvaged the hibernating and /or stunned myocardium, improved the left ventricular function. CS have offered a new, safe and effective metbods for treatment of left main trunk lesions; 3.Coronary stenting has broden the indication for invasive treatment of coronary artery diseases.
