国产冠脉雷帕霉素药物洗脱支架治疗冠心病疗效评价

目的研究国产冠脉雷帕霉素药物洗脱支架的早期临床疗效及其安全性。方法对2005年1月-2005年12月期间入选冠心病患者行冠脉造影，符合条件者行PTCA术，随机置入国产或进口冠脉雷帕霉素药物洗脱支架，观察PTCA术后半年内血管再狭窄或心脏事件。结果国产或进口支架术后近期再狭窄率均为0，无心肌梗死及死亡事件发生。结论国产支架早期临床疗效及其安全性能满足临床需要，完全可以替代进口产品。     

冠脉支架产品的不溶性微粒评价

简要介绍了不溶性微粒的定义、分类、危害、来源及控制,列举了冠脉支架产品的不溶性微粒评价方法,并分析了冠脉支架产品的不溶性微粒评价的发展趋势。     

冠状动脉支架再狭窄研究进展

支架内再狭窄使现代冠状血管成形术的发展受到限制,对于支架内再狭窄的机制、微创性诊断技术、预防措施及治疗的最佳方案一直为冠脉介入治疗领域的研究重点,文章对冠状动脉支架再狭窄近年相关研究作一综述.     

介入用钛合金毛细管材料的研制、开发与应用

血管内支架植入术已发展成为国内外治疗冠心病的主要有效手段，近年来其临床适用性已超过外科手术并逐渐为广大患者接受认可。目前采用金属内支架介入治疗的微创介入治疗技术已逐渐扩展到外周血管疾病和非血管腔内疾病的治疗，介入用金属材料、制品及其相关技术正在获得越来越广泛的应用。尽管目前国产冠脉支架产品在国内市场占有率逐年上升。但所用支架材料一医用不锈钢、TiNi等金属毛细管全部进口；国内无法生产，影响了此类产品的推广应用。大力发展血管介入用金属毛细管材料及其制品并尽快实现国产化，不仅是利国利民，也是大势所趋。     

冠脉支架医保集中带量采购执行情况及效果分析

冠脉支架集中带量采购于2021年初正式落地执行,带量采购之后冠脉支架降价明显,执行情况有待观察。本文基于某三级医院在执行冠脉支架带量采购以来半年内的数据对比执行前两年的数据,讨论研究该院冠脉支架集中带量采购的执行情况,并提出期望与建议。从冠脉支架的供应、质量、费用、医疗服务质量等方面的数据对比结果来看,带量采购前后PCI手术相关情况整体运行平稳,支架费用下降所带来的控费效果明显,可继续稳步推进球囊等相关耗材的集采工作。     

山东省冠脉支架集中带量采购存在的问题与建议

介绍了冠状动脉药物洗脱支架系统（以下简称“冠脉支架”）的发展历程，回顾性分析了国家医疗器械不良事件监测系统中山东省上报的214例冠脉支架不良事件（包括集中带量采购前110例和集中带量采购后104例）的主要表现和原因，总结了冠脉支架集中带量采购实施过程中出现的问题，提出了规范医疗行为、落实主体责任、加强监管合力等建议，为冠脉支架安全使用和监管提供了参考。     

国产爱克塞尔支架与进口西罗莫可支架疗效比较

目的探讨国产爱克塞尔雷帕霉素药物洗脱支架（Excel支架）在不稳定型心绞痛及心肌梗死患者介入治疗中的安全性和有效性。方法对70例急件冠脉综合征患者采取自愿的原则,分为两组进行对照研究,两纽患者同时期应用进口西罗莫可支架及国产爱克塞尔支架。结果自愿接受Cypher支架组28例,自愿接受Excel支架组42例。两组患者在随访期间,心绞痛、非致死性心肌梗死、支架内血栓形成、支架内再狭窄及心源性死亡等方面无统计学差异。结论Excel支架价格低廉,较Cypher支架性价比高,疗效及安全性相当,适合临床广泛应用。     

介入器械的普及应用推动了冠脉介入治疗的发展

近年来,中国心脑血管疾病患病率逐年提高,急剧增长的心脏病患者刺激了中国心脏介入手术和冠脉支架需求的快速增长,PCI手术、冠脉支架(药物洗脱支架)植入数量也大幅增加.本文主要针对心血管介入治疗器械的应用及其技术指标进行论述,并对该领域内主要器械的技术发展趋势进行了展望.     

进口或国产雷帕霉素支架治疗非左主干分叉病变对比分析

目的 研究应用进口或国产雷帕霉素支架治疗非左主干分叉病变的临床疗效.方法 入选接受冠状动脉(冠脉)双支架术治疗的冠脉非左主干真性分叉病变患者75例,随机选用进口或国产雷帕霉素药物洗脱支架治疗,完成6个月的临床随访,记录死亡、心绞痛、心功能不全、再发心梗、靶病变重建(TLR)或支架内血栓形成的发生率.结果 75例患者均完成了6个月的临床随访,死亡、再发心梗、再发胸痛、TLR、支架内血栓、心功能不全和MACE发生率在Firebird支架组分别为0%、0%、8.1%、0%、0%、2.7%、10.8%;在Cypher支架组分别为0%、0%、7.9%、0%、0%、2.6%、10.5%.两组间不良事件的差异无统计学意义(P>0.05).结论 冠心病患者的真性分叉病变均成功置入国产雷帕霉素支架,与进口雷帕霉素支架相比,不良事件的差异无统计学意义.国产雷帕霉素支架在非左主干分叉病变治疗中是安全可靠的.     

冠状动脉介入球囊扩张导管与支架在采购选型中的技术评估

近年来,随着我国介入医学的迅速发展,采用介入医疗技术开展微创介入手术已成为外科技术的发展方向。在心血管介入方面,冠脉介入治疗（PCI）已在全球广泛应用,与之相关的心血管介入球囊扩张导管、支架等医疗器械也快速发展。本文针对冠状介入治疗中使用的球囊扩张导管和冠脉药物洗脱支架等介入器械的技术发展现状、发展趋势和在采购选型中的技术评估进行分析。     

Herpesvirus Latency in Neural Cells Shown in Animal Models

Abstract

Dual antiplatelet therapy is the mainstay of medical treatment after percutaneous coronary intervention regarding the risk of stent thrombosis occurrence. Since the beginning of the stenting era, antiplatelet regimens have evolved according to the emerging and widespread diffusion of new devices and more challenging indications for their use. In the past years, concerns have been raised about the safety of drug-eluting stent implantation with regard to late and very late stent thrombosis. Thus, the length of dual antiplatelet therapy has been progressively increased with marked individual and local differences. However, prolonged antiplatelet therapy leads to increased risk of bleeding, especially in the setting of surgical procedures, traumas, and/or other diseases. To date, the exact duration of dual antiplatelet therapy after drug-eluting stent implantation is still debated in the literature. The aim of this article is to review the literature and the current guidelines on the risks and benefits of pursuing dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stent implantation.     

Next-generation drug-eluting stents in coronary artery disease: focus on everolimus-eluting stent (Xience V)

Percutaneous coronary revascularization has been a mainstay in the management of coronary artery disease since its introduction in the late 1970s. Bare-metal stents and, more recently, first-generation drug-eluting stents (DES), such as sirolimus-eluting (Cypher) and paclitaxel-eluting stents (Taxus), have further improved results of percutaneous coronary intervention (PCI) by improving early results and reducing the risk of restenosis. There is currently debate on the safety of these first-generation DES, given the potential for late stent thrombosis, especially after discontinuation of dual antiplatelet therapy. There are well known caveats on the performance of their respective metallic stent platforms, delivery, and dilation systems, and polymer coatings. Second-generation DES, such as zotarolimus-eluting (Endeavor) and everolimus-eluting stents (Xience V), have recently become available in the USA and/or Europe. The Xience V stent holds the promise of superior anti-restenotic efficacy as well as long-term safety. In addition, this stent is based on the Multi-link platform and delivery system. Recently available data already suggest the superiority of the Xience V stent in comparison to the Taxus stent in terms of prevention of restenosis, without significant untoward events. Nonetheless, the number of patients studied and the follow-up duration are still too limited to enable definitive conclusions. Only indirect meta-analyses can be used to date to compare the Xience V with the Cypher. This systematic review tries to provide a concise and critical appraisal of the data in support of the Xience V everolimus-eluting stent.     

Immediate and six months clinical and angiographic results of intracoronary paclitaxel-coated stent implantation - the Meo:DrugStar-1 study

The study was conducted to evaluate the clinical and angiographic results of the implantation of the paclitaxel-eluting stent Meo:DrugStar ST in patients with symptomatic coronary artery disease. The Meo:DrugStar ST stent has a stainless steel stent platform with a homogenous non-biodegradable coating of paclitaxel mixed with a polyether-based biostable, monophase, and hemocompatible coating. Sixty patients with native coronary artery disease were included in the study. The Meo:DrugStar ST stents were implanted in 60 de novo lesions detected in these patients. Immediate and long-term clinical and angiographic follow-up results were evaluated. There was a high proportion of patients with hypertension (55%) according to JNC-VII. Mean stenosis ratio was 78 +/- 13 %, mean implanted stent diameter was 3.0 +/- 0.4 mm and mean length was 22 +/- 5 mm. Restenosis was detected in 4 (10%) of those patients and 11 (27.5%) of 40 patients had insignificant amount of restenosis. The results of this study indicate a potential benefit of the Meo:DrugStar ST stent for the prevention of stent thrombosis and restenosis in these relatively high-risk patients.     

Stenosis Analysis软件在冠脉支架植入中的应用探索

目的探讨Stenosis Analysis软件在冠脉支架植入中的使用价值。方法通过目测判断测量包线与被测血管段的边缘吻合是否良好,来判断狭窄测量的准确性;利用完全打开的植入血管内的支架,其于狭窄段血管近端正常血管的吻合情况,来判断Stenosis Analysis软件在选择支架口径中的准确性。结果冠脉血管重度狭窄时,Stenosis Analysis软件测量精度差;轻度、中度狭窄时测量较准确;利用Stenosis Analysis软件提供的测量数值选择的支架口径与狭窄段近端正常血管吻合度很高。结论 Stenosis Analysis软件测量重度狭窄时,误差较大;对于轻、中度狭窄及正常血管的测量较精确,有临床使用价值。     

16排螺旋CT冠脉成像与冠脉造影对冠心病支架植入术后再狭窄的诊断比较

目的 探讨16排螺旋CT冠脉成像对冠心病支架植入术后再狭窄的诊断价值.方法 对2009-2010年我院65例临床冠心病支架植入术后再狭窄的患者进行常规冠脉造影,全部患者在两周后行16排CT冠脉成像对比.结果 以常规冠状动脉造影为标准,16排螺旋CT冠脉造影诊断冠心病支架植入术后再狭窄敏感率,为中度狭窄的敏感性和特异性分...     

直接冠脉支架植入治疗急性心肌梗死的有效性和安全性观察

目的:观察直接冠脉支架植入治疗急性心肌梗死的有效性和安全性。方法:回顾性分析2016年6月~2018年6月在本院心内科诊断为急性心肌梗死的患者110例,术前常规药物准备,行冠状动脉造影,判断梗死相关动脉,根据冠脉病变特点对照组行球囊预扩张后支架植入,观察组行直接支架植入。比较两组患者的手术时间、造影剂使用剂量、照射剂量和X线照射时间,并比较两组患者的不良反应发生情况。结果:观察组患者的手术时间为(41.4±7.8)min,造影剂使用剂量(114.9±39.2)mL,照射剂量(0.9±0.3)mGy,X线照射时间(8.6±1.1)min;对照组患者的手术时间为(55.2±7.3)min,造影剂使用剂量(137.1±58.7)mL,照射剂量(1.5±0.4)mGy,X线照射时间(11.8±1.2)min。组间各项比较,P<0.05,差异有统计学意义。观察组与对照组患者的不良反应发生率,P>0.05,差异无统计学意义。结论:对急性心肌梗死患者直接冠脉支架植入安全性好,且能在更短时间内完成手术,X线照射时间短,造影剂使用剂量和照射剂量小,疗效确切。     

国产乐普药物涂层支架与进口裸支架在急性心肌梗死介入治疗中的对比研究

目的:探索国产乐普药物涂层支架与进口裸支架治疗急性心肌梗死的临床研究.方法:选取2016年7月~2018年9月在本院治疗的急性心肌梗死回顾性分析了91例患者.患者被分为两组,即国产乐普药物涂层支架组(观察组):46例患者,采用国产乐普药物涂层支架方案治疗;进口裸支架组(对照组):45例患者,采取进口裸支架支架方案治疗.结果:经过治疗发现乐普支架组患者手术费用对比进口裸支架组具有明显优势(P<0.05).两组患者成功率均为100%,并且两组患者随访12个月再狭窄情况比较无差异(P均>0.05).结论:采用国产乐普药物涂层支架的方法诊治急性心肌梗死手术费用等标准比采用进口裸支架的方法理想.     

非血管药物洗脱支架制备及评价研究进展

近年来,应用支架介入治疗良恶性因素引起的非血管管腔狭窄的方法受到国内外研究者的广泛关注,尤其是恶性肿瘤疾病高发,进一步促进了支架介入治疗的发展.传统的裸支架易刺激管腔黏膜产生再狭窄等一系列并发症,药物洗脱支架的出现有望解决这一问题,成为非血管支架的重要发展趋势之一.该文综合近年的研究及应用文献,对非血管药物洗脱支架的载...