老年冠心病患者冠状动脉内支架置入术的疗效评价

目的　评价老年冠心病患者冠状动脉内支架置入术的临床疗效和安全性。方法　对比分析 49例老年 (86支血管 )和 6 1例老年前期 (98支血管 )冠心病患者冠状动脉内支架置入术的结果。结果　老年组冠状动脉病变严重、复杂病变较多 ,在复杂病变内置入支架比率高于老年前期组 ;手术即刻成功率和临床成功率均为 98.0 % ;术前病变平均狭窄率为 (94.5± 5 .6 ) % ,术后残余狭窄率为 (7.4± 8.2 ) % ;因球囊扩张不理想置入支架的为 45 .0 % ,因经皮冠状动脉腔内成形术 (PTCA)并发夹层或濒临闭塞而置入支架的比率高于老年前期组。出现严重并发症 1例(2 .0 % )。结论　老年冠心病患者冠状动脉内支架置入术成功率高 ,并发症发生率低。

Therapeutic effectiveness of intracoronary stenting in senile patients with coronary heart disease

Objective To evaluate the clinical therapeutic effectiveness and safety of intracoronary stenting in senile patients with coronary heart disease.Methods The results of coronary stenting in 49 cases (86 vessels) of senile patients who received the procedure from 1997 to 1999 were analysed and compared with those in 61 cases (98 vessels) of a non senile group.Results The lesions of coronary arteries were more severe with higher incidence of lesions of two arteries,three arteries,type B and type C in senile group than in non senile group.The senile patients had a significantly higher frequency of coronary stenting in multivessel disease.The rates of both immediate success and clinical success of operation were 98.0% in senile group.The average stenostic severity was decreased from (95.4±5.6)% before operation to (7.4±8.2)% after operation.22 stents (45.0%) were implanted due to suboptimal results after balloon angioplasty.The results did not differ significantly from those obtained in non senile group.The proportion of symptomatic improvement after the procedure was similar in the senile and non senile groups.However,the non senile patients had a significantly higher frequency of bail out stenting.There was 1 case of important complication (2.0%).Conclusions Intracoronary stenting is a good treatment method for the senile coronary heart disease with high success rate and low complication rate.