冠状动脉支架置入术后不同类型支架再狭窄形式分析

目的通过分析冠状动脉支架置入后造影复查的影像资料,寻找不同支架再狭窄的特点。方法入选行冠状动脉病变介入治疗后造影复查的846处病变,对再狭窄病变行再狭窄形式分析。结果裸支架和药物支架再狭窄中支架近端局限性再狭窄分别占5.69%和33.67%(P=0.000),而支架内弥漫性再狭窄分别占29.27%和9.18%(P=0.000),弥漫性狭窄累及支架两端的分别为20.33%和6.12%(P=0.003),闭塞性再狭窄发生率分别为9.76%和10.20%(P=0.912)。雷帕霉素及其衍生物释放支架和紫杉醇释放支架再狭窄支架边缘局限性再狭窄分别为47.06%和25.00%(P=0.037),支架内弥漫性狭窄分别为1.96%和16.67%(P=0.018)。结论药物支架改变了支架再狭窄模式,弥漫型转为局限型;闭塞性再狭窄时药物支架以支架近端闭塞为主,裸支架以支架内闭塞为主;紫杉醇药物释放支架弥漫性再狭窄发生率较雷帕霉素释放支架有所增加。

Coronary Restenosis Morphology After Intracoronary Interventional Therapy

Aim To evaluate the morphology of in-stent restenosis after different kinds of stents. Methods 846 lesions of patients who performed intracoronary interventional therapy and had angiographic follow-up in our cath lab were included in this study.Restenosis types of different drug eluting stents(DES) were analysed too. Results The focal proximal edge restenosis was 5.69% and 33.67% in bare mental stent(BMS) and DES respectively(P=0.000);Whereas the diffuse lesion in stent was 29.27% and 9.18%(P=0.000);Proliferative restenosis was 20.33% and 6.12%(P=0.003);The rate of total occlusion restenosis was 9.76% and 10.20%(P=0.912),while in DES the occlusion formed at proximal segment,and in BMS it formed in stent;Focal proximal edge restenois lesion was 47.06% and 25.00% in sirolimus eluting stent and taxol eluting stent(P=0.037);The diffuse in stent restenosis was 1.96% and 16.67%(P=0.018). Conclusion DES changed the morphology of in-stent restenosis,from diffuse restenosis to focal restenosis;Total occlusion restenosis rate in two different stents were same,but occlusion formed at proximal segment more commonly in DES while at in-stent in BMS;The diffuse restenosis lesion were common in taxus stent than that in other DES.