49例冠状动脉介入治疗再狭窄高危患者药物洗脱支架的临床应用

目的:分析经皮冠状动脉介入治疗(PCI)后再狭窄高危患者应用两种药物洗脱支架的临床疗效.方法:在17个月期间对49例再狭窄高危患者行雷帕霉素(Cypher)和/或紫杉醇(Taxus)药物洗脱支架置入术.24例患者接受Cypher支架置入术;25例患者接受Taxus支架置入术.结果:24例患者26支血管的27处病变共置入27个Cypher支架;25例患者36支血管的42处病变共置入42个Taxus支架.对49例患者平均随访7.3个月(1个月～17个月),没有1例发生术后再狭窄或进行靶血管重建或靶病变重建,但有2例在PCI后5 d(Cypher支架)和45 d(Taxus支架)分别发生了亚急性支架内血栓形成.结论:药物洗脱支架置入术即刻成功率高,在再狭窄高危患者的术后近期再狭窄发生率很低,但是术后亚急性支架内血栓形成是一个需要引起特别关注的问题.

The results of drug eluting stent in 49 patients for high risk In-stent restenosis

To describe our preliminary results of two kinds of drug eluting stents for high risk in-stent rest-enosis patients. Methods: During the past 17 months ,49 patients for high risk in-stent restenosis undertwent an implan-tation of Cypher and /or Taxus eluting coronary stents. Cypher eluting stents had been implantated in 24 patients, Tax-us eluting stents in 25 patients . Results:27 Cypher eluting stents had been implanted in 27 lesions of 26 coronary ar-teries in 24 patients ,42 Taxus eluting stents in 42 lesions of 36 coronary arteries in 25 patients and all patients under-went an average of 7. 3 month-follow-up( 1-17 months) , and no in-stent restenosis, target vessel reconstruction and tar-get lession reconstruction occurred in all patients. However, subacute and late thrombosis occurred respectively in one patient 5th day after procedure (Cypher stent) and in another 45th day after procedure (Taxus Stent). Conclusion: There is a high success rate with drug eluting stents implantation, a low in-stent restenosis incidence in the high risk in-stent restenosis patients. However,special attention should be paid to the problem of subacute stent thrombosis after the procedure.