应用血管内超声评价冠状动脉支架植入

目的 探讨血管内超声（IVUS）评价冠状动脉（冠脉）内高压球囊扩张支架植入后支架释放的效果.方法 46例患者62处冠脉病变行支架植入术后接受IVUS检查,观察支架是否充分扩张及粥样斑块负荷的变化,未达到理想扩张者再次高压扩张.结果 首次高压扩张后全部病变均达到冠脉造影理想的支架植入标准,但仅28处（45.2%）符合IVUS理想支架植入标准;34处（54.8%）病变未达到IVUS标准者进一步高压扩张后,30处达到理想标准.高压球囊扩张后原病变处仍有较大的粥样斑块负荷.结论 采用高压球囊扩张支架植入术,并不能均达到理想的支架扩张,IVUS指导下的更高压力扩张可进一步改善支架植入效果.

Assessment of clinical application of intravascular ultrasound in intracoronary stent implantation

Objective To discuss whether the application of intravascular ultrasound(IVUS) guided stent implantation was necessary.Methods IVUS was used to evaluate the effect of 62 stents in 46 patients immediately following stent deployment with high pressure(12-14 atm).If optimum stent deployment was not met,additional higher pressure dilatation would be performed.Results Of 62 stents after initial high-pressure dilatation,only twenty-eight((45.2)%) stents achieved optimum stent deployment by optimal criteria of IVUS,thirty-four((54.8)%) lesions received additional higher-pressure dilatation.There were serious residual plaque burdens in all patients after stent deployment with high-pressure.Conclusions Despite with moderately high-pressure deployment,stent implantation was not satisfied.Additional higher pressure under IVUS guidance can achieve optimizing stent deployment.IVUS guidance of stent implantation is safe and effective.