光学相干断层成像评价经皮冠状动脉介入治疗术后动脉瘤  

Optical coherence tomography in assessment of coronary aneurysms after placement of drug-eluting stents

作　　者：刘长福[1] 陈韵岱[1] 陈练[1] 孙志军[1] 刘宏斌[1] 田峰[1] 白启才[1] 郭凯[1] 

机构地区：[1]中国人民解放军总医院心内科,北京100853

出　　处：《上海医学》2009年第12期1067-1069,I0001,共4页Shanghai Medical Journal

摘　　要：目的通过光学相干断层成像(OCT)探讨冠状动脉药物释放支架置入术后动脉瘤形成的病变特点和发生率。方法331例患者药物释放支架术后6～52个月复查冠状动脉造影,对可疑动脉瘤形成的患者行OCT检查。结果331例患者中11例(15支血管)随访时发现支架部位有动脉瘤形成,发生率为3.3%。其中左前降支(LAD)、左回旋支(LCX)和右冠状动脉(RCA)的动脉瘤发生率分别为53.3%、20.0%、26.7%。OCT检查提示裸露支撑杆表面与内膜之间的平均距离为(0.512±0.223)mm,经皮冠状动脉介入治疗(PCI)术后≥12个月组的支架支撑杆表面与内膜之间的距离大于PCI术后<12个月组,但差异无统计学意义(P=0.120)。结论OCT可早期定量评价冠状动脉支架置入后形成的冠状动脉瘤。Objective To investigate the characteristics and the incidence of coronary aneurysm （CA） after placement of drug-eluting stents （DES） using optical coherence tomography （OCT）. Methods Coronary artery angiography was performed in 331 patients during 6-52 months after treatment with DES, and OCT was performed for patients who were suspected of CA. Results CA was found in 11 patients stented with drug eluting stents （15 vessels）, with the incidence being 3.3%. The incidences of CA in left anterior descending （LAD）, left circumflex （LCX） and right coronary artery （RCA） were 53. 3%, 20. 0%, and 26. 7%, respectively. OCT examination indicated that the mean distance between the endoluminal surface of the strut reflection and the intima was （0. 512 -＋ 0. 223） mm. The distance between the endoluminal surface of the strut reflection and the intima at 12 months after percutaneous coronary intervention （POI） was longer than that within 12 months after PCI （ P = 0. 120）. Conclusion OCT can be used for early assessment of CA formation after PCI in quantitative manner.

关 键 词：冠状动脉性心脏病 光学相干断层成像 支架 冠状动脉瘤 

分 类 号：R541.4[医药卫生—心血管疾病]