药物洗脱支架置人术后断裂导致支架内再狭窄的临床分析

目的 探讨药物洗脱支架(DES)置入术后支架断裂与再狭窄的关系及支架断裂的特点.方法 回顾性分析冠状动脉支架置人术后行冠状动脉造影复查的536例患者,实验分为DES组(N=397)和裸金属支架(BMS)组(n=139).分析支架置入术前、术后及复查时的冠状动脉造影图像,找出支架内再狭窄和支架断裂的病例,分析支架断裂和再狭窄的关系以及支架断裂的病变特征及形态特征.结果 DES组和BMS组再狭窄分别为31例和30例(P＜0.01),其中5例发生支架断裂,断裂的支架均为DES,BMS组未见支架断裂,两组差异有统计学意义(P＜0.05).发生支架断裂的5例靶病变均为扭曲病变,支架断裂均发生在血管扭曲成角处.结论 支架断裂是DES置入术后发生再狭窄的原因之一,扭曲病变置入长的DES后可能容易发生支架断裂.

Association between stent fracture and restenosis after drug-eluting stent implantation

objective This study Wag performed to evaluate the relationship between the stent fracture and restenosis after drug-eluting stent implantation.Methods The study enrolled 536 patients with and BMS group(n=139).The coronary angiography images were analyzed to detect restenosis and stent fracture.Results Restenosis rate was significantly lower in DES group(31/397,7.8%)compared that in BMS group(30/139,21.6%,P＜0.05).Stent fracture(n=5)was found only in DES group and not in BMS group(P＜0.05).Restenosis Were found in all stent fracture segments.The stent fracture developed at the angulated tortuosity lesions.Conclusion Stent fracture is one of the causes of restenosis after drug-eluting stents implantation and related to implantation of long DES stent at tlle location of angulated tortuosity lesions.