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|本期目录/Table of Contents|

不同支架植入方式对小血管支架内再狭窄的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第6期
页码:
786-789
栏目:
临床研究
出版日期:
2011-12-25

文章信息/Info

Title:
Effects of different implantation modes of drug-eluting stents on restenosis of small vessel lesions
作者:
郭素峡1; 羊镇宇1; 王如兴1; 肖践明2
1.无锡市人民医院心脏中心，江苏 无锡 214023；2.昆明医学院第一附属医院心内科，云南 昆明 650031
Author(s):
GUO Su-xia1;  YANG Zhen-yu1;  WANG Ru-xing1;  XIAO Jian-ming2
1.Heart Center, Wuxi People’s Hospital, Wuxi 2140232, Jiangsu, China; 2.Department of Cardiology, First Affiliated Hospital, Kunming Medical College, Kunming 650031, Yunnan, China
关键词:
小血管; 支架植入; 预扩张; 再狭窄
Keywords:
small vessel;  implantation;  drug-eluting stent;  balloon predilation: in-stent restenosis
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:观察不同支架植入方式对小血管（血管直径≤2.75 mm）支架内再狭窄的影响。方法： 对69（男51，女18）例患者共111处病变进行治疗，实验组（n=38）直接植入支架64枚（雷帕霉素药物洗脱支架53枚,紫杉醇药物洗脱支架11枚），对照组（n=31）预扩张后植入支架47枚（雷帕霉素药物洗脱支架41枚,紫杉醇药物洗脱支架6枚），两组患者术后即刻行冠脉血管内超声(IVUS)检测最小支架直径及横截面积。术后有胸闷胸痛症状患者即刻行冠脉造影术及IVUS，无症状患者6个月后复查。通过IVUS检测，对两组管腔丢失及支架内再狭窄率进行比较。结果： 两组支架植入术后即刻最小支架直径实验组为（2.38±0.26）mm，对照组为（2.34±0.24）mm（P＞0.05）；支架横截面积实验组为（4.5±1.0）mm2，对照组为（4.3±0.9）mm2（P＞0.05）；6个月随访后复查两组管腔丢失，实验组为（1.44±0.30）mm，对照组为（0.98±0.24）mm（P=0.01）；支架内再狭窄发生率实验组为15 %；对照组为30%（P＜0.05）。结论： 对冠状动脉小血管病变患者直接药物洗脱支架植入组支架内再狭窄发生率低于预扩张后支架植入组。
Abstract:
AIM:To investigate the effects of different implantation modes of drug-eluting stents upon restenosis of small vessel lesions (diameter ≤2.75 mm). METHODS: Sixty-nine patients (51 males and 18 females) with 111 lesions were enrolled after implanting drug-eluting stents. The experimental group consisted of direct implantation of drug-eluting stents and the 64 stents included 53 rapamycin and 11 paclitaxel drug-eluting stents. The control group consisted of implanted drug-eluting stents after balloon predilation and the 47 stents included 41 rapamycin and six paclitaxel drug-eluting stents. After procedures, coronary angiography and intravascular ultrasound (IVUS) were performed immediately in case of chest pain. For those without chest pain, coronary angiography and IVUS were performed after 6 months. In-stent restenosis was detected by IVUS and the rates of in-stent restenosis were compared between groups. RESULTS: The average diameters of small vessels immediately evaluated postoperatively in experimental group and control group were, respectively (2.38±0.26)mm and (2.34±0.24)mm (P>0.05). The average cross-sectional areas of lumens of small vessels in experimental group and control group were, respectively, (0.26±0.30) mm2 and (4.3±0.9) mm2 (P>0.05). However, 6 months postoperatively, the loss of lumens in experimental group and control group were (1.44±0.30) mm and (0.98±0.24) mm, respectively (P=0.01) and the ratios of in-stent restenosis were 14.60% and 29.78%, respectively (P<0.05). CONCLUSION: For patients with small vessel lesions, direct implantation of drug-eluting stents is superior to implanting drug-eluting stents after balloon predilation.

参考文献/References

[1]Li JJ,Xu B,Yang YJ,et al.Drug-eluting stent for the treatment of small coronary lesion: comparison between sirolimus- and paclitaxel-eluting stent[J].Chin Med J (Engl),2007,20(7):569-573.

[2]Kastrati A,Schoming A,Dirschinger J,et al.A randomized trial comparing stenting with balloon angioplasty in small vessels in patients with symptomatic coronary artery disease. ISAR-SMART Study Investigators.Intracoronary Stenting or Angioplasty for Restenosis Reduction in Small Arteries[J].Circulation,2000,102(21):2593-2598.

[3]Douct S,Schalij MJ,Vrolix MC,et al.Stent placement to prevent restenosis after angioplasty in small coronary arteries［J］. Circulation, 2001, 104(17):2029-2033.

[4]Haude M,Konorza TF,Kalnins U,et al.Heparin-coated Stent placement for the treament of stenosis in small coronary arteries of symptomatic patients[J].Circultion,2003,107(9):1265-1270.

[5]Koning R,Eltchaninoff H,Commeau P,et al. Stent placement compared with balloon angioplasty for small coronary arteries in-hospital and 6-month clinical and angiographic results[J].Circulation,2001,104(14):1604-1608.

[6]Kastrati A, Schomig A,Dirschinger J,et al.A randomized trial comparing stenting with balloon angioplasty in small vessels in patients with symptomatic coronary artery disease[J].Circulation,2000,102(21):2593-2598.

[7]Umeda H,Iwase M Gochi T,et al.Safety and efficacy of 2.5-mm sirolimus-eluting stent implantation at lower deployment pressures in very small vessels (<2.5 mm)[J].Coron Artery Dis, 2009,20(2):163-168.

[8]李为民,霍 勇,吕树铮.冠心病介入治疗策略与技巧[M].北京:人民卫生出版社, 2007:122-129.

[9]Ardissino D,Cavallini C,Bramucci E,et al.Sirolimus-eluting vs uncoated stents for prevention of restenosis in small coronary arteries:A randomized trial[J].JAMA,2004,292(22):2727-2734.

[10]Lee CW,Suh J,Lee SW,et al.Factors predictive of cardiac events and restenosis after sirolimus-eluting stent implantation in small coronary arteries[J].Catheter Cardiovasc Interv,2007,69(6):821-825.

[11]Moliterno DJ.Healing Achilles-Sirolimus versus paclitaxel[J].N Engl J Med,2005,353(7):724-727.

[12]Finn AV, Palacios IF, Kastrati A, et al. Drug-eluting stents for diabetes mellitus: a rush to judgment?［J］. J Am Coll Cardiol,2005,45(4):479-483.

备注/Memo

备注/Memo:
收稿日期: 2011-04-20.通讯作者：羊镇宇，主任医师，主要从事临床冠心病研究Email：yangzy@wuxiph.com 作者简介：郭素峡，住院医师，硕士Email：guo7771812@163.com
更新日期/Last Update: 2011-12-27