冠脉内超声在冠状动脉内支架置入中的意义  

Intracoronary Ultrasound Guidance in Intracoronary Stent Implantation

作　　者：蔡煦[1] 张大东[1] 沈卫峰[1] SchieleFBassandJP 

机构地区：[1]上海第二医科大学附属瑞金医院心脏科,200025 [2]法国Besancon大学医学院圣雅克医院心脏科

出　　处：《上海第二医科大学学报》1999年第1期9-11,共3页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的对41例冠心病患者冠状动脉在血管内超声（IVUS）指导下置入支架，评价造影和IVUS及一个月随访结果。方法理想支架置入IVUS标准：支架内截面积≥近端和远端相关血管腔截面积平均值的80％。结果支架置入后25例达到标准，不需再扩张；14例IVUS不满意者（造影结果良好）过扩张支架，支架内截面积增加25．7％（P＜0．05）；2例因超声导管未跨过支架无超声资料。最终35例（90％）得到满意IVUS（支架内最小截面积8．5±2．2mm^2），结合阿司匹林和噻氯匹定治疗，无一例死亡、心肌梗塞和支架内血栓形成。结论IVUS是指导冠脉支架置入安全有效的手段。Objective To observe the immediate angiographic and intravascular ultrasound (IVUS) results and their effects on the one month clinical outcomes in forty - one patients submitted to coronary stent deployment with IVUS guidance and aspirin and ticlopidine therapy. Methods All patients were allocated to coronary stent implantation with high inflation pressure. After good angiographic result (＜20% residualstenosis), all patients underwent IVUS and overdilatation would be necessary if criteria for optimal coronary stent implantation were not met. The optimal criterion of IVUS for stent implantation was the ratio of intrastent lumen cross - sectional areas to the averageof the proximal and distal reference lumen cross - sectional areas≥80%. All patients took aspirin and ticlopidine therapy at the day of angioplasty and during one month follow - up. ResultsOptimal criterion of IVUS was obtained without any further intrastent dilatation in twenty- five patients but in fourteen patients whose ultrasound results did not reach the criterion intrastent overdilatation was performed so as to increase minimal intrastent lumen area 25.7 %(P＜0.05). At last, thirty - five patients (90%) had good minimal intrastent lumen area of IVUS. There were no deaths, myocardial infarction, acute stent thrombosis or need for revacularization in our study during one month follow-up.Conclusion Intracoronary stent deployment under the IVUS guidance combining aspirin and ticlopidine therapy had beneficial ultrasound results and good clinical outcomes of one month follow - up.

关 键 词：冠心病 PTCA 冠状动脉内超声 介入疗法 

分 类 号：R654.2[医药卫生—外科学] R541.405[医药卫生—临床医学]