冠状动脉内支架植入术321例分析

目的：评价冠状动脉内支架的临床价值。材料与方法：321例冠心病患者冠状动脉内植入451个支架，植入成功率97．8／，其中79．1％（254例）为B2型以上复杂性病变，因DeNovo及Suboptimal病变植入的支架占56.7％（182／321），Bail－out病变16．5％（53／321），再狭窄病变26.8％（86／321）。结果：28例曾行冠状动脉搭桥水患者的28文静脉移植血管（SVG）内植入49个支架，16例急性心肌梗塞患者接受原发支架植入。多支架植入99例，其中植入3个以上支架者26例。支架类型：Palmaz－schatz支架占69.7％（314个），NIR支架占20．6％（93个），其它支架占9．8％（44个）。多数病例使用高压球囊扩张，住院期间发生急性支架血栓形成6例（1．9％），亚急性支架血栓形成2例，其中1例因心肌梗塞死亡，无严重出血并发症。21例（6.5％）术后2－11个月胸痛复发者支架部位再狭窄，再次PTCA。结论：冠脉内支架是一种安全有效的介入性治疗技术．其扩大了PTCA的适应症，成功率高，并发症低，并减少再狭窄的发生。

Clinical evaluation of coronary stenting (321cases )

Purpose: Coronary stenting has become recognised technology to reduce restenosis and as a bail-out procedure for PTCA. Material and methods:From May 1995 to August 1996, 451 intracornary stents were implanted on 321 coronary artery disease patients. The majorty had type B2 and Clesion. Stenting was indicated for restenosis in 86 patients and the rest were De Novo lesions with suboptimal results after PTCA due to either dissection or recoil,and in 53 cases as bail -out procedure for acute or threatened closure. Results: The use of a variety of different stent designs in essential to maintain appropriately high levels of procedure success.Those stents include 314 Palmaz - Schatz, 93 NlR, 22ACS, 8 Micro, 7 Cordis, 4 cook, 2 GRII, 1 Wallstent. 179 stents were into 139 LAD, 165 in 113 RCA, 4o in 26 LCX, 12 in 10 OM, 3in 2 LADD,, 49 in 28 SVG, 3 in 3LM. The procedure success rate was 97. 856, Acute or subacute thrombosis occurred in 8 cases. No severe bleeding were observed in hospital stay. Restenosis was found in 21 cases with an incidence of 6. 5 %. Conclusion:Intracoronary stenting is a safe and efficient interventional procedure with a high success rate and very a few complications. It may reduce restenosis rate.