雷帕霉素洗脱支架冠状动脉造影随访结果分析

目的通过对接受雷帕霉素洗脱支架(sirolimus-eluting stent,SES)治疗的冠心病患者冠状动脉造影随访,观察其临床实际应用的效果。方法339例患者接受治疗,所有患者均接受了临床随访,165例患者于置入术后6~12个月行冠状动脉造影复查。结果冠状动脉造影随访时,支架近端边缘晚期管腔丢失显著高于支架内及支架远端边缘(0.17 mmvs0.08 mmvs0.09 mm),再狭窄率为9.7%,再血管化率4.84%,再狭窄以局限性狭窄为主。在339例患者中,有4例患者于支架置入后5天~4个月发生猝死。猝死发生率为1.18%。1例于支架置入后14天发生支架内亚急性血栓形成,发生率0.50%。晚期血栓形成1例(术后12个月),主要心血管不良事件为1.70%。结论对复杂的冠状动脉病变SES有较好的疗效,能显著降低支架后再狭窄,减少靶血管的再血管化率。

Coronary angiographic follow-up study of the result after sirolimus-eluting stent implantation

Objective To evaluate the angiographic result in patients treated with sirolimus-eluting stent(SES) implantation in clinical practice.Methods Three hundred and thirty-nine patients were treated with SES implantation and received clinical follow-up.165 of them underwent angiographic follow-up from 6 to 12 months after the operation.Results During angiographic follow-up,the late loss of lumen proximal to the stent was higher than in-stent late loss and late loss distal to the stent(0.17 mm vs 0.08 mm vs 0.09 mm).The restenosis rate was 9.7% and revascularization rate was 4.84%.Four patients died suddenly from 5 days to 4 months after the procedure.One patient developed subacute thrombosis 14 days after the procedure and one developed late thrombosis.The rate of the main adverse cardiovascular events(MACE) was 1.70%.Conclusions Unrestricted utilization of SES in daily practice is effective in reducing both restenosis and revascularization.