TAXUS支架治疗急性冠状动脉综合症的疗效评价

目的评价紫杉醇洗脱冠状动脉支架(TAXUStmBoston公司产品)应用于急性冠状动脉综合症病人的临床疗效及安全性。方法自2003年5月至2004年12月接受TAXUS支架治疗的94例急性冠状动脉综合症患者,观察术后即刻效果、术后6个月心脏性死亡、心肌梗塞、再次血管重建及冠状动脉造影复查情况。病例中包括ST段抬高的急性心肌梗塞27例,非ST段抬高的急性心肌梗死8例,不稳定心绞痛59例。结果支架植入成功率为99%,术中和随访期间无死亡,术后1例出现亚急性血栓,1例晚期血栓致心肌梗塞,另有5例随访中进行了血管重建术,6个月主要心脏不良事件(MACE)发生率7.4%。术后6～7个月23例的冠状动脉造影复查再狭窄率为13.0%(支架内为8.6%),靶病变重建率为2.7%。结论应用TAXUS支架治疗急性冠状动脉综合症是安全和有效的,支架内再狭窄率明显低于普通金属支架。

An evaluation of short and long-term outcomes of TAXUS stent in patient with acute coronary syndrome

Objective To investigate the effect and security of TAXUS stent (p aclitaxel-eluting stent) in patients with acute coronary syndrome (ACS). Method s From November 2002 to December 2004, 94 patients with ACS had 120 TAXUS stents placed. Twenty-seven out of 94 had ST-segment elevation myocardial infarction ; 8 had non-ST-segment elevation myocardial infarction and 59 had unstable ang ina. As for lesion characteristics, diffuse disease was found in 19 case, bifurc ation lesions in 21 cases, chronic severe occlusion lesions in 19 cases, in-ste nt restenosis in 5 cases and ostial lesions in 6 case . The immediate angiograph ic outcome, six mouth follow-up results with major cardiac evrdiac event (MACE ) and follow-up angiography in 6-7th mouth had been assessed. Results Successf ul stent-placing procedure was achieved in 99%patients with ACS. Sub-acute st ent thrombosis occurred in 1 patient, late stent thrombosis leading to AMI occur red in 1 patient. There was no death during the procedure and 6-month follow-u p. The MACE rate during hospitalization was 0.0%and was 7.4%during 6 month fol low-up. Follow-up study performed in 6-7th month showed that restenosis rate (ISR) was 13.0%(in-stent restenosis rate was 2.7%). And the target vessel revascularization (TLR) rate was 2.7%. Conclusion TAXUS stent implantation in the treatment of ACS is safe and effectiv e, providing a significantly lower ISR rate than the convetional metal stents.