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1.
目的 探讨国产雷帕霉素药物洗脱支架Firebird在急性ST段抬高心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)中应用的安全性和近、远期疗效。方法 选择我院心内科2005年3月-2006年6月收治的STEMI且在发病12h内接受急诊置入雷帕霉素药物洗脱支架的患者105例,分为Cypher组(33例)和Firebird组(72例)。比较2组住院期间和随访10个月时心脏事件(MACE)的发生率。结果 Cypher组33例梗死相关血管的33处病变置入42枚Cypher支架,Firebird组72处梗死相关病变置入113枚Firebird支架。支架置入成功率为100%。无再流现象:Cypher 1例,Firebird 组2例(P=1.000)。Cypher组心脏破裂死亡1例,Firebird组亚急性支架内血栓形成死亡1例。住院期间MACE发生率Firebird组为1.4%(1/72),Cypher组3.0%(1/33)(P〉0.1),临床PCI成功率91.4%(96/105)。对86例患者进行了平均[10.2±4.2(6-20)]个月随访,Cypher组28例和Firebird组58例;再发心绞痛3例,Cypher组1例和Firebird组2例;Firebird组术后3个月心衰死亡1例;随访时MACE发生率:Firebird组3.4%(2/59),Cypher组3.4%(1/29)(P=1.000)。结论 国产雷帕霉素药物洗脱支架Firebird在STEMI急诊PCI中应用安全有效,近、远期疗效与Cypher支架相近。  相似文献   

2.
目的 评价药物洗脱支架应用于冠心病超长病变(≥50 mm)的安全性、有效性.方法 选取68例行经皮冠状动脉介入治疗(PCI)的冠心病超长病变患者置入Cypher支架、Firebird支架及Taxus支架,记录患者的治疗、在院期间和随访等情况.结果 68例患者PCI治疗均获成功,共置入Cypher支架84枚、Firebird支架42枚、Taxus支架69枚.1例合并糖尿病者术后出现支架内亚急性血栓,2例发生非Q波型心肌梗死,其他患者住院期间均无严重并发症发生.随访6~12个月,患者均未发生主要心脏不良事件,36例患者术后6~9个月行冠状动脉造影复查,其中3例发生支架内再狭窄并行外科搭桥术.结论 药物洗脱支架在冠心病超长病变PCI治疗中安全、有效,但需进一步评价.  相似文献   

3.
目的探讨国产雷帕霉素药物洗脱支架Firebird在急性ST段抬高心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)中应用的安全性和近、远期疗效。方法选择我院心内科2005年3月 ̄2006年6月收治的STEMI且在发病12h内接受急诊置入雷帕霉素药物洗脱支架的患者105例,分为Cypher组(33例)和Firebird组(72例)。比较2组住院期间和随访10个月时心脏事件(MACE)的发生率。结果Cypher组33例梗死相关血管的33处病变置入42枚Cypher支架,Firebird组72处梗死相关病变置入113枚Firebird支架。支架置入成功率为100%。无再流现象:Cypher1例,Firebird组2例(P=1.000)。Cypher组心脏破裂死亡1例,Firebird组亚急性支架内血栓形成死亡1例。住院期间MACE发生率Firebird组为1.4%(1/72),Cypher组3.0%(1/33)(P>0.1),临床PCI成功率91.4%(96/105)。对86例患者进行了平均[10.2±4.2(6 ̄20)]个月随访,Cypher组28例和Firebird组58例;再发心绞痛3例,Cypher组1例和Firebird组2例;Firebird组术后3个月心衰死亡1例;随访时MACE发生率:Firebird组3.4%(2/59),Cypher组3.4%(1/29)(P=1.000)。结论国产雷帕霉素药物洗脱支架Firebird在STEMI急诊PCI中应用安全有效,近、远期疗效与Cypher支架相近。  相似文献   

4.
目的:观察Cypher雷帕霉素药物洗脱支架在急性ST段抬高心肌梗死(ASTEMI)中的临床研究.方法:入选2003年10月至2005年6月确诊ASTEMI患者76例行急诊冠脉造影和PCI,冠脉造影后明确病变,然后行PTCA及支架置入.在PCI过程中置入Cypher西罗莫司药物洗脱支架.观察术中、住院、出院后有无严重心脏不良事件(包括死亡、非致命急性心肌梗死、靶病变靶血管重建率、再次入院).结果:所有患者均经桡动脉行介入治疗,冠脉造影和支架的成功率为100%.共置入Cypher支架86枚,置入1个支架的患者为66例,置入2个支架的为10例.在支架长度中,支架≥28mm的有38枚支架,<28mm的有48枚支架.在支架直径中,支架≥3.0mm的有76枚支架,<3.0mm的有10个支架.放入支架后梗死相关血管前向血流达TIMI3级的有69例,发生无复流的有3例,它们在术中、术后均应用Tirofiban.3例患者(3.9%)在住院期间发生不良事件.1个月随访发现1例三支血管病变患者在出院后1周猝死.出院后4~6个月以上随访有4例患者出现心绞痛入院行冠脉造影.其余患者无不适症状等.共有11例患者(14.4%)在支架术后4~7个月复查冠脉造影,再狭窄率为0%.4例出现心绞痛患者造影发现其它血管狭窄(既往存在)而行支架.结论:Cypher雷帕霉素药物洗脱支架在ASTEMI中的应用是安全和有效的,明显减少再狭窄率.  相似文献   

5.
目的 探讨国产药物洗脱支架(Firebird)对冠心病小血管病变介入治疗的安全性和近中期临床效果。方法 对2005年10月~2006年10月于我院进行药物支架介入治疗的114例(Firebird支架56例,Gypher支架58例)冠心病小血管病变患者进行随访观察6~10个月,并重复造影评价再狭窄及血管重建情况。结果 支架置入成功率为100%,术中无急性血栓形成、急性血管闭塞及死亡。临床随访及复查造影显示,Firebird组支架内再狭窄患者5例(8.9%),3例(5.4%)再次血管重建治疗,其中1例(1.8%)患者进行了外科血管重建治疗。Cypher组支架内再狭窄患者5例(8.6%),2例(3.4%)再次血管重建治疗。结论 应用国产药物洗脱支架(Firebird)对小血管病变进行介入治疗,具有良好的安全性和满意的近、中期疗效。  相似文献   

6.
147例国产雷帕霉素洗脱支架Firebird治疗冠心病疗效观察   总被引:1,自引:0,他引:1  
目的:评价应用国产药物洗脱支架Firebird的临床疗效.方法:选择2004年9月~2007年3月147例置入Firebird支架治疗的冠心病患者进行临床观察,随访1~30个月,11例复查冠状动脉造影.结果:147例患者共置入Firebird支架279枚,手术即刻成功率100%,住院病死率0.6‰,靶病变血管重建术为0,心脏不良事件发生率为1.3%.随访中未发现与Firebird支架相关的再狭窄依据,其中11例患者经冠脉造影证实无再狭窄.结论:上述观察显示Firebird支架能有效治疗冠脉狭窄,减少冠脉支架术后再狭窄,具有很高的安全性及应用前景.  相似文献   

7.
目的对比研究国产雷帕霉素洗脱支架(Firebird)和进口雷帕霉素洗脱支架(Cypher)对急性冠脉综合征(ACS)患者12个月疗效。方法选取ACS患者220例均于发病后12h内行急诊介入治疗(PCI),随机分为Firebird支架和Cypher支架两组,其中Firebird支架组120例,Cypher支架组100倒。220例患者共植入Firebird支架142枚,Cypher支架112枚。结果两组患者靶血管特征差异无显著性(P均>0.05)。两组患者靶血管直径和靶病变长度对比(P均>0.05)。临床随访1年,两组均各有1例急性支架内血栓形成,各有1例死亡。无亚急性、慢性血栓形成、再发心肌梗死。再发心绞痛、再次血运重建和主要心血管事件(MACE)比较差异无显著性(P均>0.05)。结论国产和进口雷帕霉素洗脱支架治疗ACS近期疗效相似。  相似文献   

8.
目的:总结非ST段抬高性心肌梗死(NSTEMI)患者行急诊介入治疗(PCI)的临床疗效及随访结果.方法:2000年2月~2005年2月间,共收治142例NSTEMI患者,年龄36~82岁;其中6例行外科搭桥(CABG)治疗,136例行急诊PCI;发病到急诊PCI时间为1.5~11h.结果:136例行PCI者,131例成功,成功率96.3%.共治疗133处病变,置入支架177枚,4例患者仅行球囊扩张术.2例死亡,1例死于心源性休克,1例死于颅内出血.2例术后1周内支架内亚急性血栓形成.住院期间无其他严重心血管事件发生.129例患者门诊随访12个月,无不良心血管事件发生,86例PCI患者术后6~12个月行冠脉造影检查,再狭窄10例,8例金属裸支架者(16%)、2例药物洗脱支架者(5.6%).结论:非ST段抬高型心肌梗死急诊介入治疗安全有效,能明显改善临床症状.药物洗脱支架可降低再狭窄发生率.  相似文献   

9.
目的:探讨在老年急性心肌梗塞(AMI)急诊经皮冠状动脉介入治疗(PCI)中植入雷帕霉素药物洗脱支架(CypherTM)及普通裸支架对C反应蛋白(CRP)及预后的影响。 方法:45例老年急性AMI患者,分为CypherTM支架组(n=23)和裸支架组(n=22),所有患者在术前、术后6 h、术后1 d、术后7 d、术后1个月测定CRP,临床随访造影及主要心血管事件。 结果:CypherTM支架组23例患者共植入27枚支架,术后TIMI血流3级23例,成功率100%;22例接受随访,随访时间3~11个月,无支架内再狭窄及心血管事件等发生。裸支架组22例患者共植入支架26枚,术后TIMI血流3级21例,临床成功率为95.5%;20例接受随访,随访时间5~13个月,2例患者发生支架内再狭窄(再狭窄率9.09%)。1例猝死,2例新生 血管病变。两组术后6 h、术后1 d CRP水平与术前相比明显增高(P<0.05)。两组之间比较差异无显著性。结论:应用CypherTM支架治疗老年AMI近期安全有效。  相似文献   

10.
目的探讨雷帕霉素药物洗脱支架(Cypher^TM)在急性ST段抬高性心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)中的早期疗效。方法选择2004年1月至2005年6月的STEMI患者100例,随机分为两组:药物支架组50例和普通支架组50例,所有患者均于发病12 h内行急诊PCI治疗,一组置入Cypher^TM,另一组置入普通支架。比较两组支架置入情况及早期临床事件发生率。结果100例患者急诊PCI治疗均获得成功。药物支架组95支梗死相关血管(IRA)的99处病变置入98枚药物洗脱支架,普通支架组77支IRA的81处病变置入83枚普通支架。药物支架组1例介入治疗后第3天猝死。药物支架组和普通支架组相比较,手术成功率及PCI后造影结果和临床结果比较差异均无统计学意义。随后对99例病人进行了1-6个月随访,药物支架组有较低的再狭窄率和较少的心血管事件发生率(6.0%、16.0%和8.0%、14.0%,P〈0.01)。结论STEMI患者在PCI中应用Cypher^TM支架早期临床效果优于普通支架。  相似文献   

11.
目的评价Excel在ACSPCI中的安全性和有效性。方法87例ACS患者,其中ST段抬高性心肌梗死39例,非ST段抬高性心肌梗死22例,不稳定型心绞痛26例,在行PCI过程中置入国产药物洗脱支架—Excel支架。结果所有患者均成功地完成了PCI,共置入Excel支架132枚,随访期间无严重心脏不良事件发生,17例患者术后6个月复查冠状动脉造影,仅1例直径狭窄50%。结论国产药物洗脱支架可安全、有效地应用于ACS患者。  相似文献   

12.
目的 评估Firebird药物洗脱支架(DES)加替罗非班与Cypher支架加替罗非班治疗急性冠脉综合征(ACS)病人的安全性和有效性.方法 2005年7月至2007年7月323例ACS病人,其中接受Firebird支架(Firebird组)161例,接受Cypher支架(Cypher组)162例.两组同时加用替罗非班.首先给予负荷量10μg·kg-1,3 min内静注完毕,之后以0.15 μg·kg-1·min-1的速度微量泵持续静点36 h.比较两组支架植入后即刻到近期的有效性和安全性,并于30 d内进行随访,比较有效性和主要不良心脏事件的发生率.结果 Firebird组与Cypher组比较,术前左室射血分数、靶病变的部位、血小板计数、血红蛋白、红细胞压积差异均无统计学意义.两组手术成功率均为100%,术后出血并发症、血小板计数、血红蛋白、红细胞压积差异均无统计学意义,两组各有2例发生支架内急性血栓(1.2% vs 1.2%,P>0.05).均无亚急性血栓发生、非致死性心肌梗死各2例(1.3% vs 1.3%)、靶血管再次重建分别为1例(0.6%),2例(1.3%)、再住院分别为2例(1.3%)1例(0.6%)差异均无统计学意义(均P>0.05).30 d随访均未见支架内再狭窄.结论 Firebird药物洗脱支架加用冠替罗非班治疗ACS均有较好的安全性和有效性,具有与Cypher支架相似的临床疗效.  相似文献   

13.
目的:探讨药物涂层支架在冠心病合并糖尿病患者介入治疗中的临床疗效。方法:并发糖尿病的冠心病患者90例常规冠状动脉造影,进行经皮冠状动脉介入治疗,其中44例植入国产雷帕霉素药物涂层支架(Firebird组),46例植入国产紫杉醇药物涂层支架(垠艺组),术前术后常规使用阿司匹林和氯吡格雷,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83.3%,Firebird组植入雷帕霉素药物涂层支架77枚,垠艺组植入垠艺支架82枚,所有患者均获得成功。平均随访6.2±1.3个月,其中Firebird组复发心绞痛3例,1例发生心肌梗死。垠艺组复发心绞痛3例,1例发生心肌梗死。Firebird组发生再狭窄2例,垠艺组发生再狭窄2例。两组无支架内血栓形成和死亡。结论:垠艺支架对冠心病并发糖尿病患者的近期疗效与Firebird支架相似。  相似文献   

14.
Background Randomized clinical trials have demonstrated equivalent safety to bare-metal stents after drug-eluting stents (DES) implantation. However, the DES thrombosis in randomized trials could not be comparable to those observed in clinical practice, frequently including off-label indications. This study sought to assess the incidence of DES thrombosis after implantation of DES in patients with real world coronary artery disease (CAD) in China.
Methods From December 2001 to April 2007, 8190 consecutive patients received the treatment with DES, 5412 patients completed one year follow-up: 2210 with sirolimus-eluting stent Cypher, 1238 with paclitaxel-eluting stent Taxus and 1964 with Chinese sirolimus-eluting stent Firebird, After two years of follow-up, there were 2176 patients (1245 Cypher, 558 Taxus and 373 Firebird). All patients were treated with aspirin and clopidogrel over at least 9 months.
Results Among 8190 patients, 17 patients had acute stent thrombosis (0.24%): 7 in the Cypher group, 4 Taxus and 6 Firebird; 23 patients had subacute stent thrombosis: 8 Cypher, 6 Taxus and 9 Firebird. The incidence of acute and subacute thrombosis was 0.49%: 0.50% Cypher, 0.63% Taxus and 0.41% Firebird. The incidence of late thrombosis at one year followup was 0.63%: 0.63% Cypher, 0.88% Taxus and 0.46% Firebird; at two year follow-up the incidence was 0.74%: 0.72% Cypher, 0.90% Taxus and 0.54% Firebird. There was no significant difference among three groups at 1 year and 2 years follow-up.
Conclusion The first generation DES in the treatment of complex lesions are safe and effective if patients are aggressively treated with dual antiplatelet agents.  相似文献   

15.
Background Late stent thrombosis (LST) is still concerned by interventions cardiologists in daily clinical practice. This study aimed to compare the incidence of LST after implantation of different drug-eluting stents (DES) in coronary heart disease (CHD) patients in the real world.Methods From December 2001 to February 2009, a total of 11 875 consecutive CHD patients undergone DES implantation were enrolled in this single-center registery study. Patients with acute ST-segment elevation myocardial infarction, mixed DES implantation, restenosis lesions, and patients who could not take dual antiplatlet medication and those who were contraindicated for coronary interventional treatment were excluded. All patients were treated with completed dual antiplatelet medications for at least 9 months after DES deployment. The follow-up was completed by outpatient visits, letter correspondence, phone calls and coronary angiography. Definite LST was diagnosed auording to the Academic Research Consortium (ARC) definition.Results Cypher or Cypher Select stents were implanted in 4104 cases, Taxus or Taxus Liberty stents in 2271 cases and Firebird stents (Chinese rapamycin-eluting stents) in 5500 cases. One-year follow-up was completed in 9693 patients, including 3346 cases with Cypher or Cypher Select stents, 1529 cases with Taxus or Taxus Liberty stents and 4818 cases with Firebird stents. Two- and three-year follow-up results were obtained in 7133 and 4353 patients, respectively, including 2410 and 1760 cases with Cypher or Cypher Select stents, 1285 and 900 cases with Taxus or Taxus Liberty stents as well as 3438 and 1693 cases with Firebird stents. One-year follow-up results showed that the incidence of LST was 1.08% in patients with Cypher or Cypher Select stents, 1.24% in those with Taxus or Taxus Liberty stents and 0.71% in those with Firebird stents; there was no significant difference between those with Cypher or Cypher Select and Firebird stents, but there was significant difference between those with Taxus or Taxus Liberty and Firebird stents (P=0.044). The incidence of LST at the 2- and 3-year follow-up was 1.33% and 1.70% in those with Cypher or Cypher Select stents, 1.40% and 1.70% in those with Taxus or Taxus Liberty stents, and 0.83% and 0.95% in those with Firebird stents, respectively. There were no significant differences among the three groups.Conclusions This study indicates that first-generation DES are acceptable to treat complex coronary lesions, and there is no significant difference of LST for three different DES.  相似文献   

16.
Background Several clinical trials have shown that rapamycin-eluting stents significantly reduce the risk of restenosis after percutaneous coronary intervention (PCI). The Firebird stent and the Excel stent (coated with bioabsorbable polymer) are two different types of rapamycin-eluting stents made in China, both have been recently approved for clinical use in China by State Food and Drug Administration. However, it is unclear whether there are differences in safety and efficacy between the two types of stents in daily practice. Methods In the month of June 2006, a total of 190 consecutive patients were treated exclusively with Firebird stents (n=93, Firebird group) or Excel stents (n=97, Excel group) in our center and were included in this study. The frequency of major adverse cardiac events (MACE, a composite of death, myocardial infarction or target lesion revascularization), binary restenosis, and late lumen loss and stent thrombosis during a six-month follow-up period were compared between the two groups.Results Patient and lesion characteristics were comparable between the groups. Major adverse cardiac event rates were low in hospital and at 6 months (2.1% in the Excel group and 0% in the Firebird group, P﹥0.05). The 6-month angiographic in-stent restenosis rate was 0% in both groups, with an associated late loss of (0.15 ± 0.21) mm versus (0.14 ± 0.20) mm (P=0.858) and the in-segment restenosis rate was also 0% for the Excel group and the Firebird group. There was no definite stent thrombosis identified in either group during the six-month follow-up period and only one patient in the Excel group had probable stent thrombosis in hospital. Conclusions Results from this mid-term, single-center study showed that both of the Firebird and the Excel rapamycin eluting stent had similar effects on reducing the incidence of MACE and the risk of restenosis (both in-stent and in-segment binary restenosis) after PCI in daily practice.  相似文献   

17.

Background  The sirolimus and paclitaxel distribution patterns and tissue residence time may be modified in atherosclerotic lesions for patients with diabetes, and the biological mechanisms of action for these agents differ significantly. Previous clinical trials have yielded discrepant results of major adverse cardiac events and restenosis between a sirolimus-eluting stent and a paclitaxel-eluting stent in coronary artery disease. Therefore, this study was conduced to compare in-hospital and long-term clinical outcomes between patients receiving sirolimus-eluting stent (Cypher or Cypher Select stent) and paclitaxel-eluting stent (Taxus Express stent) after percutaneous intervention (PCI) in Chinese patients with diabetes.
Methods  One hundred and sixty-four consecutive diabetic patients underwent PCI in Fuwai Hospital from April 2004 to December 2004. Of them, 101 patients received Cypher or Cypher Select stents (Cypher group, 145 stents) and 63 patients received Taxus Express stents (Taxus group, 129 stents). Repeat coronary angiography was performed at 6-month and clinical outcomes were evaluated at 1- and 3-year follow-up. Stent thrombosis was classified according to Academic Research Consortium (ARC).
Results  The two groups did not differ significantly with respect to cardiac death, recurrent myocardial infarction (re-MI), target vessel revascularization (TVR) and occurrence of major adverse cardiac events (MACE). And the MACE-free cumulative survival at 1- and 3-year follow-up and early, late and very late thrombosis rates were also similar in the two groups (all P>0.05). There was a trend favoring PES over SES with regard to reducing cardiac death (0 vs 2.0%, P=0.524), re-MI (0 vs 2.0%, P=0.524), the composite of the cardiac death and re-MI (0 vs 4.0%, P=0.299) and very late thrombosis (0 vs 3.0%, P=0.295) between 1-year and 3-year follow-up.
Conclusion  The study indicates that PCI with either Cypher or Taxus stents is associated with similar efficacy and safety in the small population of Chinese diabetic patients during long-term follow-up.

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18.
赖沙毅  陈维芊  李娟  谢剑  梁云  伍海芬 《华夏医学》2006,19(6):1066-1067
目的通过复查冠脉造影观察国产药物洗脱支架择期治疗冠心病的临床疗效。方法择期接受Firebird支架(雷帕霉素洗脱支架)治疗的57例冠心病患者,78支病变血管的90处罪犯病变置入98枚Firebird支架,随访6~9个月并复查冠脉造影。结果支架内再狭窄率为3.51%。结论国产药物洗脱支架具有良好的临床疗效。  相似文献   

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