心肌桥介入治疗后支架内再狭窄及其再次治疗效果的观察  

Observation of Stent Restenosis after Stent Implantation for Myocardial Bridge Lesion.

作　　者：马辉[1] 王宁夫[1] 潘浩[1] 童国新[1] 

机构地区：[1]杭州市第一人民医院心内科,浙江杭州310006

出　　处：《心脑血管病防治》2007年第4期229-231,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的观察心肌桥病变介入治疗的再狭窄率及其治疗效果。方法选择有症状的单纯心肌桥改变且收缩期严重狭窄(≥95%)者17例作治疗组(A组),对照组选择单纯前降支动脉粥样硬化严重狭窄(≥70%)者54例(B组),两组均应用普通冠脉支架介入治疗。结果两组介入手术均成功,两组支架植入后的血管内径及支架长度比较无显著差别(P>0.05)。A组6个月内8例(47%)出现再狭窄,B组8例再狭窄(14.8%),A组和B组的再狭窄率有显著差别(P<0.05);两组中再狭窄病人均再次接受治疗。平均随访20月,A组8例中7例未再发生支架内狭窄及心绞痛事件,1例再次支架内狭窄,B组再次介入治疗的6例中1例再次支架内狭窄。结论心肌桥病变的介入治疗远期疗效尚好,但远期支架内再狭窄率较高,需再次介入治疗。Objective To assess the efficacy of long term stent implantation for myocardial bridge lesion and severe atherosclerosis lesions in the segments proximal to the myocardial bridge. Methods The study population consisted of 76 patients including 17 patients with symptomatic myocardial bridge lesion of luminal narrowing more than 95 percent （Group A） and 59 patients with severe atheresclerosis lesion of luminal narrowing more than 70 percent （Group B）. All lesions were in left anterior descending coronary artery and treated with coronary stent by standard interventional technique. Quantitative coronary angiography was performed before and after stent implantation and again at six months afterwards. Clinical follow up was done up to 20 months. Results All procedures were successful in two groups. There was no significant difference in luminal diameter and stem diameter immediately after stent implantation （ P 〉 0.05）. At 6 months, restenosis occurred in 8 patients of group A（47%）, and 8 cases in group B（ 14.8% ）. The rate of restenosis was signiticandy higher in group A than in group B （ P 〈 0.05）. In group A, 7 restenosis patients were performed additional ballon dilating in stent and 1 patient was reimplanted another DES stent. On clinical evaluation at 20 months, all patients with treatment for stem resternosis remained free of angina and cardiac events except one. Conclusions There is a high rate of restenosis in intracoronary stent implantation for myocardial bridge, though which can be treated by pereutaneoas coronary intervention again.

关 键 词：心肌桥 冠脉内支架植入术 冠状动脉粥样硬化性心脏病 

分 类 号：R541.1[医药卫生—心血管疾病]