冠状动脉长病变串联置入雷帕霉素和紫杉醇洗脱支架重叠部分对分支血管影响的比较

目的 回顾性分析对于冠状动脉长病变串联置入雷帕霉素洗脱支架(Cypher)与紫杉醇洗脱支架(TAXUS)时,支架的重叠部分对直径<2.0 mm的分支血管的影响.方法 回顾2004年1月至2007年10月间在北京协和医院行择期经皮冠状动脉介入治疗(PCI)且至少有1支靶血管进行了串联置入药物洗脱支架的141例患者的光盘和临床资料,排除急性心肌梗死和急性冠状动脉综合征的患者.按照置入药物洗脱支架的种类分为Cypher组和TAXUS组,对比分析两种不同的药物洗脱支架串联置入时重叠部分对直径<2.0 mm的分支血管血流的影响.结果 共有141例患者人选,其中男性115例,女性26例.共置入支架297枚,累及分支血管154支.其中Cypher支架组入选83例,TAXUS支架组入选58例.PCI术后支架重叠部位分支血管的闭塞率Cypher支架组为24.6%,TAXUS支架组为31.6%;支架重叠部位分支血管血流减慢Cypher支架组为26.3%,TAXUS支架组为68.4%.两组差异无统计学意义.多种因素回归分析结果表明:分支血管直径、分支血管开口狭窄是分支血管闭塞的独立危险因素.结论 与TAXUS组相比,Cypher组支架重叠部位较少引起分支血管闭塞,但两者差异无统计学意义.分支血管开口狭窄和分支血管直径是影响支架重叠部位分支血管闭塞的主要因素.

Side btanch occlusion rate at sites of overlapping sirolimus-or pacfitaxel-eluting stents for treating long coronary lesions

Objective To compare side branch occlusion rate at sites of overlapping sirolimus-or pacilitaxel-eluting stents in treating long coronary lesions.Methods We retrospectively reviewed the PCI CD and medical records of PCI 141 patients with at least one stent overlapping for long coronary lesion in our institute from January 2004 to October 2007.The side branches occlusion Was documented and analyzed.Results The study population were consisted of 141 patients that there were 115 man,and 26 women,who got 297 stents.There were 154 side branch vessels been observed.Side branch occlusion rate Was 24.6% in Cypher group and 31.6% in TAXUS (P>0.05),side branch TIIMI flow decrease rate on overlapping region was 26.3% in Cypher group and 68.4%in TAXUS group (P>0.05).A logistic regression model analysis show that the significant risk factors for side branch occlusion is the diameter and ostial occlusion of side branch.Conclusion Side branch occlusion rate and TIMI flow decrease rate were similar on overlapping region in patients treated with Cypher or TAXUS stents for long coronary lesions.The significant predictors for side branch TIMI flow decrease are the diameter and ostial occlusion of side branch.