药物洗脱支架置入术后断裂导致支架内再狭窄的临床分析  

Association between stent fracture and restenosis after drug-eluting stent implantation

作　　者：田峰[1] 陈韵岱[2] 孙志军[2] 刘长福[2] 杨庭树[2] 宋现涛[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,100029 [2]解放军总医院心内科

出　　处：《中华心血管病杂志》2009年第1期35-38,共4页Chinese Journal of Cardiology

摘　　要：目的探讨药物洗脱支架（DES）置入术后支架断裂与再狭窄的关系及支架断裂的特点。方法回顾性分析冠状动脉支架置入术后行冠状动脉造影复查的536例患者，实验分为DES组（n=397）和裸金属支架（BMS）组（n=139）。分析支架置入术前、术后及复查时的冠状动脉造影图像，找出支架内再狭窄和支架断裂的病例，分析支架断裂和再狭窄的关系以及支架断裂的病变特征及形态特征。结果DES组和BMS组再狭窄分别为31例和30例（P〈0．01），其中5例发生支架断裂，断裂的支架均为DES，BMS组未见支架断裂，两组差异有统计学意义（P〈0．05）。发生支架断裂的5例靶病变均为扭曲病变，支架断裂均发生在血管扭曲成角处。结论支架断裂是DES置入术后发生再狭窄的原因之一，扭曲病变置入长的DES后可能容易发生支架断裂。Objective This study was performed to evaluate the relationship between the stent fracture and restenosis after drug-eluting stent implantation. Methods The study enrolled 536 patients with angiographies during stenting procedure and follow-up, the patients were divided into DES group （ n = 397 ） and BMS group（n = 139）. The coronary angiography images were analyzed to detect restenosis and stent fracture. Results Restenosis rate was significantly lower in DES group （31/397, 7. 8% ） compared that in BMS group （30/139, 21.6%, P 〈0.05）. Stent fracture （n =5） was found only in DES group and not in BMS group （ P 〈 0. 05 ）. Restenosis were found in all stent fracture segments. The stent fracture developed at the angulated tortuosity lesions. Conclusion Stent fracture is one of the causes of restenosis after drugeluting stents implantation and related to implantation of long DES stent at the location of angulated tortuosity lesions.

关 键 词：冠状动脉疾病 支架 冠状动脉再狭窄 

分 类 号：R686[医药卫生—骨科学]