冠状动脉药物洗脱支架与支架内血栓

支架内血栓是冠状动脉支架术后少见但却严重危及生命的并发症。药物洗脱支架由于降低了再狭窄率而使冠状动脉粥样硬化性心脏病介入治疗领域发生了革命性的变化,但对其增加晚期血栓的顾虑成为目前关注的热点。支架内血栓的形成除了支架本身的致栓作用外,还与患者、病变及手术等因素相关。此外,过早中断双联抗血小板治疗、延迟再内皮化及晚期支架贴壁不良等均与支架内血栓密切相关。本文就支架内血栓的定义、发生机制及对策等进行综述。

Drug-eluting Stems in Coronary Artery and Stent Thrombosis

Stent thrombosis is a rare, but severe eomplicat/on with high morbidity and mortality after stent implantation. Drug-eluting stents （ DES ） revolutionized interventional cardiology owing to their pro- nounced ability to reduce restenosis compared with bare-mental stents, while not reduced, even increased the incidence of stent thrombosis. Patient-, lesion-, procedure-related facors as well as thrombogenicity of the stent itself are involved in the pathogenesis of stent thrombosis. Furthermore, premature cessation of dual antiplate- let theraphy,delayed re-endothelialization,late acquired stent malapposition all correlates with an increased risk of stent thrombosis. This review focuses on the definition, pathophysiological mechanisms and counter- measure of stent thrombosis,