首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到19条相似文献,搜索用时 234 毫秒
1.
冠状动脉内Palmaz—Schatz支架植入术70例分析   总被引:11,自引:0,他引:11  
为评价冠状动脉内Palmaz-Schatz支架的临床效果,我们回顾性总结分析了70例冠心病患者74支冠状动脉血管80个Palmaz-Schatz支架植入的临床成功率、并发症及远期疗效。结果:DeNovo支架植入63个,Suboptimal支架植入11个,Bail-out支架植入4个,再狭窄病变支架植入2个。左前降支37处病变植入41个支架,左回旋支11处病变植入11个支架,右冠状动脉25处病变植入  相似文献   

2.
目的:评估老年冠心病患者PTCA的疗效和安全性。方法:212例冠心病患者中,稳定型心绞痛46例、不稳定型心绞痛62例、心肌梗死104例。A组(112例)冠脉造影示:单支血管病变84例,双支血管病变62例、三支血管病变66例。共处理病变血管298处,置入支架252枚。其中LAD118处,RCA84处,LCX84处,LM2处。比较A组(≥60岁)和B组(<60岁)的临床特点,冠脉病变情况及PCI的临床疗效。结果:A组多支血管病变较之B组增多(P<0.01),两组手术成功率无显著性差异。结论:PTCA和支架术安全、有效,成功率高、严重并发症少,也适用于60岁以上患者。  相似文献   

3.
目的 评价国产BuMA生物降解药物涂层冠状动脉支架在冠心病小血管病变经皮冠状动脉介入治疗中的临床疗效及安全性.方法 选择182例行经皮冠状动脉介入治疗(PCI)的冠心病患者,其中小血管病变组102例,大血管病变组80例,均置入BuMA生物降解药物涂层冠状动脉支架,比较观察手术成功率、术中并发症及在1~12个月随访期间的心绞痛、猝死、主要不良心脏事件(MACE)发生率及复查冠状动脉造影情况.结果 大血管病变组和小血管病变组手术即刻成功率均为100%,两组共发现203处靶病变,共置入支架273枚.术中均无严重并发症发生.对入选182例患者进行出院后第1、3、6、12个月门诊随访发现,小血管病变组8例心绞痛复发,其中1例为糖尿病患者.大血管病变组5例复发心绞痛.于术后第6~9个月复查冠状动脉造影证实,小血管病变组2例分别为右冠状动脉主干、左前降支支架内远段再狭窄达75%~80%,大血管病变组1例为左前降支支架近端再狭窄75%.两组心绞痛复发、冠状动脉造影支架内再狭窄及靶病变血运重建主要MACE发生率的差异均无统计学意义.两组均未出现迟发性支架内血栓、无心肌梗死及猝死.结论 国产BuMA生物降解药物涂层冠状动脉支架应用于冠心病小血管病变介入治疗安全、有效,疗效不逊于用于冠心病大血管病变时.  相似文献   

4.
评价冠状动脉支架治疗冠心病的远期疗效。方法 对冠心病植入冠状动脉支架 (简称支架 )半年以上随访 ,观察远期疗效。 45例 ,男 37例 ,女 8例 ,年龄 34~ 75岁。不稳定心绞痛 31例 ,劳累心绞痛 11例 ,急性心肌梗塞 3例。选择性冠状动脉造影显示单支病变 9例 ,双支病变 2 0例 ,三支病变 16例。A型病变 5例 ,B型病变 19例 ,C型病变 2 1例。血管狭窄 70 %~ 10 0 % ,其中完全闭塞 11例。LVEF 0 .36~ 0 .92 ,平均 0 .5 3。 5 3处血管病变植入 6 4个不同种类的血管支架。结果 无心肌梗塞和死亡 ,39例临床症状明显改善 ,心绞痛完全消失 ,6例复发心绞痛。 9例在术后 3~ 15个月做冠脉造影复查 ,1例右冠脉植入支架处的远端血管完全闭塞 ,其余 8例无再狭窄。结论 冠状动脉支架治疗冠心病具有较好远期疗效。  相似文献   

5.
为评价冠状动脉内Palmaz-Schatz支架的临床效果,我们回顾性总结分析了70例冠心病患者74支冠状动脉血管80个Palmaz-Schatz支架植入的临床成功率、并发症及远期疗效。结果:DeNovo支架植入63个,Suboptimal支架植入11个,Bail-out支架植入4个,再狭窄病变支架植入2个。左前降支37处病变植入41个支架,左回旋支11处病变植入11个支架,右冠状动脉25处病变植入27个支架,1处病变植入1个支架。支架植入的成功率为98.7%。术中1例SVG支架植入术中近端血管血栓形成。住院期间无亚急性支架血栓形成或严重出血性并发症。术后3~24个月30例患者共33个支架接受冠状动脉造影随访,6例6个支架节段血管有再狭窄,再狭窄率为18.7%。结果提示:冠脉内Palmaz-Schatz支架是一种安全有效的介入性治疗技术,其成功率高,并发症率低,并可能有降低或延缓血管再狭窄发生的作用  相似文献   

6.
目的:探讨经皮冠状动脉腔内成形术(PTCA)和冠脉内支架植入术治疗冠心病的可行性和安全性。方法:分析43例PTCA和冠脉内67个支架植入术的资料。其中8处病变行单纯PTCA,12处病变直接植入支架;植入支架类型包括Cordis支架49个,NIR支架16个,CVD1个,AVE1个,靶血管病变特征;A型病变35处,B型30处,C型10处,支架植入病变血管分布为左主干1个,左前降支31个,对角支2个,左回旋支16个,右冠状动脉17个,结果:手术成功率100%,术前冠脉狭窄程度为80-95%,术后残余狭窄小于5%,管腔通畅,血流恢复TIMI Ⅲ级,随访2-36个月,4例患有支架内再狭窄,再狭窄率9.3%,结论:PTCA和冠脉内支架植入术成功率高,疗效显,是治疗冠心病心绞痛和心肌梗死的重要而有效的手段。  相似文献   

7.
张孝忠  张晋  张军  王红  原新茹 《心脏杂志》2010,22(3):393-395
目的:对比氮氧化钛生物有效性支架(Titan2-BAS)与雷帕霉素药物洗脱支架(sirolimus-eluting stent,SES)在冠状动脉血运重建方面的临床疗效。方法:冠心病患者141例,根据植入的支架不同分为A组(Titan2-BAS)87例,B组(SES)54例,A组病变内径(3.1±0.4)mm,长度(24±3)mm,B组病变内径(3.0±0.5)mm,长度(22±4)mm,两组无显著差异。均采用经桡动脉或尺动脉途径冠脉血运重建。A组阿司匹林与氯吡格雷治疗1~3月,B组至少12月。计算A,B两组支架病变的通过率、早期支架内血栓发生率及随访MACE发生率(指死亡、急性心肌梗死、靶血管重建等)。结果:A组146处75%狭窄病变共植入Titan2-BAS 168枚,1枚支架未能通过病变(RCA),通过率99.3%;B组86处病变共植入SES94枚,通过率100%,两组无显著差异。随访1~17(平均5.8)月。两组均无死亡病例;A组无急、晚期血栓。B组1例术后2 d出现支架内血栓;A组1例术后3月行靶血管重建,B组无靶血管重建;两组MACE发生率无显著差异。结论:Titan2-BAS与SES在冠脉血运重建方面的近期及远期疗效相近,Titan2不增加MACE发生率。  相似文献   

8.
小血管支架的临床应用   总被引:1,自引:0,他引:1  
目的 评价具有磷酸胆碱涂层的小血管支架治疗细小冠状动脉病变 (≤ 3 0mm)的疗效。方法 选择 4 5例冠心病患者 ,男 35例 ,女 10例 ,年龄 (5 4 2± 10 5 )岁。常规行冠状动脉造影 ,以美国GE公司研制的血管造影机 (GEAdvantx)测量系统实时测量病变血管直径。小于 3 0mm的病变血管共 5 4支 ,平均血管直径为 (2 0± 0 4 5 )mm ,植入PC涂层 (BiodivYsioSV)支架 5 9个。结果  5 4支病变血管均经球囊扩张后植入支架 ,手术成功率为 10 0 %。支架植入后平均狭窄直径减至 0 %~10 %,无一例急性或亚急性支架内血栓形成。全部病例随访 (6± 2 4 )个月 ,无一例死亡。 10例于术后(4± 1 2 )个月出现心绞痛复发 ,经冠状动脉造影证实 8例为支架内再狭窄 ,2例出现其他部位血管病变。结论 应用具有磷酸胆碱涂层的支架治疗小血管病变 ,再狭窄率低 ,临床疗效肯定。  相似文献   

9.
目的 :评价应用具有磷酸胆碱涂层的小血管支架治疗中远端细小冠脉的病变 (≤ 2 5mm)的疗效。方法 :选择 60例冠心病患者 ,年龄 5 4 2± 10 5岁。男 4 6例 ,女 14例 ,常规行冠状动脉造影 ,对病变血管以美国GE公司血管造影机测量系统实时测量病变血管直径 ,<2 5mm病变血管共 69支 ,平均血管直径 2 0± 0 4 5mm ,植入BiodivYsioSV支架 74个。结果 :69支病变血管均经球囊扩张后植入支架 ,手术成功率 10 0 %。支架植入后病变平均狭窄直径减至 0 %~ 10 % ,无 1例急性 亚急性支架内血栓形成。全部病例随访 6± 3 8个月 ,无 1例死亡。 15例于术后 4± 1 2个月心绞痛复发 ,经冠脉造影证实13例为支架内再狭窄 ,2例出现新部位血管病变。结论 :应用具有磷酸胆碱涂层支架治疗小血管病变 ,再狭窄率低 ,临床疗效肯定  相似文献   

10.
观察国产Firebird支架在冠心病患者介入治疗中的临床疗效。方法共140例冠心病患者常规冠状动脉造影后行经皮冠状动脉介入(PCI)治疗,其中64例患者植入Firebird支架,76例患者置入普通支架,术前术后除常规使用阿司匹林和波立维外,同时给予严格的内科强化治疗,术后进行随访。结果冠状动脉造影显示2支以上血管病变占70.56%,一共植入Firebird支架114枚,普通支架105枚,所有患者均获得成功。平均随访(10.2±3.3)个月,其中药物支架组复发心绞痛18例,10例发生心肌梗死;普通组复发心绞痛40例,16例发生心肌梗死。部分患者行冠脉造影复查,Firebird支架组发生再狭窄2例,普通支架组发生再狭窄8例,均进行了靶病变重建术。结论Firebird支架对冠心病患者近期疗效确切,能减少再狭窄的发生。  相似文献   

11.
Background/purposePercutaneous coronary intervention (PCI) of diffuse coronary artery disease (CAD) is associated with higher adverse clinical events. This study aimed to compare the clinical outcomes of patients treated with single long 48 mm contemporary drug eluting stents (SL-DES) versus two overlapping contemporary drug eluting stents (OL-DES) for very-long CAD.Methods/materialsWe analyzed the clinical outcome of 117 patients with SL-DES and 101 patients with OL-DES who underwent PCI between 1st July 2013 to 31st December 2016. The primary endpoint was target lesion failure (TLF) at two years, defined as a composite of cardiac mortality, target vessel myocardial infarction and target lesion revascularization.ResultsMean age was 60.8 ± 10.5 years for SL-DES group and 60.5 ± 11.9 years in the OL-DES group. SL-DES has longer mean lesion length as compared to OL-DES (43.1 ± 3.7 mm vs. 41.83 ± 2.3 mm p = 0.003). There was no difference in TLF at two years between SL-DES and OL-DES (5.3% vs. 6.4%, adjusted odds ratio 1.43, 95% CI 0.50–4.11). There was one case of probable ST in each group. Contrast volume usage was lower for SL-DES than OL-DES in patients who underwent single vessel PCI.ConclusionsTreatment of very-long CAD showed comparable TLF at two years for SL-DES versus OL-DES. Our results suggest that both strategies are reasonable treatment options for patients with diffuse CAD.  相似文献   

12.
OBJECTIVE: To assess the safety and efficacy of concurrent implantation of sirolimus-eluting (SES) and paclitaxel-eluting (PES) stents in the same coronary artery. BACKGROUND: When it is impossible to deliver multiple drug eluting stents (DES) of the same type, the operator must opt to implant a different DES or a bare metal stent. There are currently no published data evaluating this approach. METHODS: We identified all cases in which one or more SES and PES were implanted in either the same lesion or adjacent segments of the same vessel during a single procedure between March 2003 and March 2005. Endpoints analyzed were; in-hospital major adverse cardiac events (MACE), and follow-up MACE (including stent thrombosis). RESULTS: We identified 44 patients with 89 lesions. This was a complex cohort of patients with a median of 3.5 stents implanted, 3 lesions and 2 vessels treated and a median stent length implanted of 80.5 mm, while 83% of the lesions were type B2/C. Eight patients had peri-procedural myocardial infarction. During follow-up; 1 cardiac death occurred, no patients had a myocardial infarct or stent thrombosis, 11 underwent target lesion and vessel revascularization (25%) and 13 had a major adverse cardiac event (29.5%). CONCLUSIONS: In this cohort of patients, the concurrent use of SES and PES in the same vessel was associated with outcomes in keeping with the complexity of disease treated. Our data show that it is not unreasonable to implant different DES in the same vessel, although we would not advocate this as routine practice.  相似文献   

13.
INTRODUCTION: The most effective strategy for bifurcation stenting is currently undefined. The Culotte technique was developed as a method that ensures complete bifurcation lesion coverage. However, it went out of favour due to a high rate of restenosis when utilizing bare metal stents. Drug‐eluting stents reduce the rate of restenosis and need for repeat lesion revascularization compared with bare metal stents; we re‐evaluated this technique with drug‐eluting stent implantation. METHODS: Between April 2002 and October 2003, 207 patients were treated for at least one bifurcation lesion with drug‐eluting stent implantation to both the main vessel and side branch. Of these, 23 were treated with the Culotte technique (11.1%) for 24 lesions. Sirolimus‐eluting stents were used in 8.3%, and paclitaxel‐eluting stents in the remaining 92.7%. RESULTS: Clinical follow‐up was obtained in 100%. One patient had a myocardial infarction at 14 days (maximum rise in creatine kinase 872IU/L) related to thrombosis occurring in another lesion, and underwent repeat revascularization. There were no episodes of stent thrombosis in the Culotte lesions. At eight months follow‐up, there were no deaths and no further myocardial infarction. One patient required target lesion revascularization (TLR), and a second underwent target vessel revascularization. The cumulative rates of survival‐free of TLR and major adverse cardiac events were 94.7% and 84.6% respectively. Angiographic follow‐up was obtained in 16 patients (69.6%) at a mean period of 8.3±4.3months. The late lumen loss for the main vessel and side branch were 0.48±0.56?mm and 0.53±0.33?mm respectively, with binary restenosis rates of 18.8% and 12.5%.

CONCLUSIONS: In this small study of bifurcation stenting utilizing the Culotte technique with drug‐eluting stent implantation, there was a low rate of major adverse events and need for target lesion revascularization at eight months, when compared with historical data of bifurcation stenting with bare metal stents. Further re‐evaluation of this technique utilizing drug‐eluting stents, is warranted in the setting of larger randomized studies.  相似文献   

14.
Buszman P  Zurakowski A  Kinasz L  Gorycki B  Król M  Lewicki A  Flak Z  Milewski K  Zurek P 《Kardiologia polska》2005,62(5):451-9; discussion 460-1
AIM: The aim of the present study was to assess the safety and efficacy of percutaneous coronary interventions (PCI) using the new Polish stent "Chopin" (Balton, Poland). METHODS: The study consisted of experimental and clinical parts. In the experimental phase, the new stent was implanted into 5 pigs and control coronary angiography as well as intracoronary ultrasonography (ICUS) were performed 30 days later. In the clinical phase, 101 patients (57% of males, mean age 55.6+/-10 years) with symptomatic coronary artery disease (CAD) with "de novo" coronary lesions (including 12% of patients with unstable angina and 19% with acute myocardial infarction [MI]) underwent stent implantation. The patients were followed for 6 months for the occurrence of cardiac events. Quantitative coronary angiography was performed at baseline and after 6 months. RESULTS: In total, we attempted to implant 107 stents, which resulted in the successful deployment of 106 stents to 105 coronary arteries. The mean diameter of the stents was 3.2+/-0.3 mm, and length - 15.4+/-2 mm. During a one month follow-up period no cardiac events were noted. During a 6-month follow-up no death or new MI were recorded. Repeated target vessel revascularisation due to recurrent angina and in-stent restenosis was required in 15 (15.5%) patients. Control coronary angiography was performed in 97 (96%) patients. Of 101 stents, angiographic restenosis (narrowing of dilated lesion by >50% of vessel lumen) was documented in 18.8% of cases. The mean late vessel lumen loss was 0.77+/-0.6 mm, and stenosis - 29.1+/-20%. The restenosis rate was significantly higher in patients with unstable angina rather than in those with stable angina or acute MI. CONCLUSIONS: Implantation of the new Polish stent "Chopin" during PCI is safe and effective.  相似文献   

15.
Background: In patients with coronary artery disease (CAD), there is an increasing therapeutic need among interventional cardiologists to conduct dual antiplatelet therapy (DAPT) whose duration is shorter than current guideline‐recommended 6–12 months after the implantation of drug‐eluting stents. However, no clinical grounds sufficient to rationalize the need are available. Objectives: To define the optimal duration of DAPT and to examine the safety and efficacy of the Endeavor zotarolimus‐eluting stent (E‐ZES) in real‐world Japanese patients with CAD. Study design: The present prospective, nonrandomized, multicenter, controlled study is uniquely designed to examine the analysis set to be formulated after integrating two different databases consisting of the following two study arms: the 3‐month DAPT arm, in which 1,210 patients were consecutively enrolled at 106 medical institutions; and the 12‐month DAPT arm, in which 1,210 patients will be consecutively extracted from the Endeavor Japan post‐marketing surveillance at 60 medical institutions. The primary endpoint is “net adverse cardiac and cerebrovascular events—death, myocardial infarction, cerebrovascular accident, and major bleeding)” at 12 months after implantation. The secondary endpoints are as follows: major adverse cardiac events at 1, 3, 6, 9, and 12 months after implantation; target vessel revascularization and target lesion revascularization at 9 and 12 months after implantation; and stent thrombosis, DAPT compliance, and bleeding events at 12 months after implantation. Noninferiority in the E‐ZES's profiles between the study arms will be investigated. Conclusions: The present study will provide insight into the optimal duration of DAPT after the E‐ZES implantation in individual, real‐world patients with CAD. © 2013 Wiley Periodicals, Inc.  相似文献   

16.
OBJECTIVE: To compare the efficacy of drug eluting stents (DES) compared with bypass surgery (CABG) with left internal mammary artery (LIMA) in patients with single vessel disease suffering from chronic stable angina. BACKGROUND: There are a limited number of studies investigating this group of patients. METHODS: We included 257 consecutive patients with isolated lesion in the proximal segment of left anterior descending artery (LAD). All patients suffered from chronic stable angina or from stress-induced ischemia. Of 257 patients, 147 underwent DES implantation and 110 CABG with LIMA. All patients were followed-up clinically for major adverse cardiac events. RESULTS: The baseline demographic and angiographic characteristics were similar between the two groups. In the DES group we used sirolimus-, paclitaxel-, and ABT-578-eluting stents. The mean duration of hospitalization after CABG was 7.86 +/- 3.84 days vs. 1.02 +/- 0.19 days after PCI (P < 0.01). The incidence of MACE was 2.72% in the DES and 2.72% in the surgical group during a mean follow-up period of 18.71 +/- 6.27 months for PCI and 18.70 +/- 7.31 months for CABG (P = 0.99). There was one cardiac related death in the DES group and two in the surgical group (P = 0.58). There were three reinterventions in the DES group versus none in the surgical group (P = 0.26). Recurrence of angina was observed in 4.08% of pts in the DES group versus 6.36% in the CABG group (P = 0.57). CONCLUSIONS: The present study demonstrated that patients suffering from chronic stable angina with isolated lesion in the proximal segment of LAD have excellent long-term outcome in both surgical and DES treatment.  相似文献   

17.
目的比较雷帕霉素洗脱支架(CYPHER)与紫杉醇洗脱支架(TAXUS)治疗多支冠状动脉病变患者的疗效及安全性。方法2003年6月至2004年12月在我院置入药物洗脱支架的416例多支病变冠心病患者,剔除合并左主干病变、急性心肌梗死、再次血管重建及合用普通支架者。随机分为两组:CYPHER支架组210例,TAXUS支架组206例。比较两组支架术后近期及远期疗效。结果支架置入术前两组患者冠心病危险因素、心功能状况及冠状动脉病变特征无统计学差异。两组PCI手术成功率、平均支架置入数(3.24±1.25)比(3.19±1.38)枚/例及并发症发生率均无统计学差异。术后平均随访(19.5±8.9)个月,总随访率、心绞痛复发率、造影复查再狭窄率、主要不良心脏事件发生率、心功能改善率及无事件存活率均无统计学差异。与CYPHER支架组比较TAXUS支架组术后亚急性血栓发生率有增高趋势,但无统计学差异(1.0%比0.5%,P>0.05)。用QCA测量术后6~9个月冠状动脉造影结果,支架内最小管腔直径(MLD)、节段内MLD、支架内晚期管腔丢失及节段内晚期管腔丢失两组间比较均无统计学差异。结论多支冠状动脉病变患者置入CYPHER和TAXUS两种药物洗脱支架均能达到成功率高,再狭窄率低,远期临床疗效好的结果,两者疗效及安全性无统计学差异。  相似文献   

18.
目的评价药物洗脱支架治疗不稳定型心绞痛(UAP)的临床疗效。方法对我院138例UAP患者经标准药物治疗3~7d后日常活动仍有心绞痛发作或运动试验阳性者行冠状动脉造影检查。对病变血管狭窄〉70%且为经皮冠状动脉介入治疗(PCI)适应证的病变处行PCI并植入药物洗脱支架,共治疗病变血管202支,植入支架243个。结果支架植入成功率100%,术中和住院期间无死亡病例。1例于术后3h发生支架内血栓形成。138例患者随访6~24个月,1例死于出血性脑卒中,2例猝死,8例进行了靶血管血运重建。7~18个月共复查冠状动脉造影37例,支架内在狭窄5例。135例患者心绞痛症状完全消失或明显减轻,三例患者症状改善不明显。结论药物洗脱支架治疗UAP疗效满意。  相似文献   

19.
目的:分析雷帕霉素药物洗脱支架CypherTM植入后对急性冠脉综合征患者近、远期的不良反应.方法: 选择接受CypherTM治疗的冠心病患者83例,在支架植入术后9个月内全部接受门诊随访及冠脉造影,了解支架内急性和亚急性血栓、边缘效应、贴壁不良现象、支架处动脉瘤发生率及相应的不良心脏事件(MACE)发生情况.结果:83例患者共植入支架112个,植入成功率为98.8%(82/83).29例(34.9%)接受冠脉造影,MACE9例,发生率10.8%(9/83),其中,1例术中发生猝死,1例术后3d因亚急性血栓造成再发心肌梗死,其余7例在出院后1~3 月内发生心绞痛,皆经造影证实为血栓形成,再次成功靶血管血运重建8例;其余20例无症状患者造影发现支架边缘狭窄(无血栓)2例,总再狭窄为13.3%(11/83);无动脉瘤发生.9例MACE中,有弥漫病变5例,其中4例植入长支架,1例植入重叠支架,其余为简单病变;29例患者共发现贴壁不良现象5例,皆发生MACE,其中4例为弥漫病变植入长支架,1例为简单病变.结论:急性或亚急性血栓形成是药物支架CypheTM植入后出现的主要不良反应,可能与弥漫病变植入长、重叠支架引起贴壁不良有关.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号