完全闭塞性冠脉血管成形术中冠脉内支架的应用及其限制因素  

Criterias and limitations of stent implantation for recanalized chronic total occlusion

作　　者：杜志民[1] 胡承恒[1] 李怡唐 安丽 伍贵富[1] 何汉康 易春 金思榄[1] 马虹[1] 

机构地区：[1]中山医科大学附属第一医院,广州510080 [2]广西柳州地区医院 [3]湖北丹江口市汉江集团医院

出　　处：《中国介入心脏病学杂志》1999年第3期97-99,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的　评价冠状动脉（冠脉）内支架在完全闭塞性冠脉血管成形术（ＰＴＣＡ）中应用的指征及其限制因素。方法　８２ 例冠脉完全闭塞接受ＰＴＣＡ 患者，根据血管病变性质，决定是否给予置入支架治疗。分析支架应用的指征及其限制因素。术后随访６ 个月，发生心脏事件者行血管造影复查。结果　８２例中，６６ 例相关冠脉再通成功，成功率为８０．５％ 。６６ 例中，Ａ 组２３ 处病变单纯球囊ＰＴＣＡ 后取得“支架样”效果，其中Ｂ１ 组３０ 处病变置入支架，支架置入率４５．５％ ，Ｂ２ 组１３ 处病变存在支架置入的限制因素而未置入支架，占１９．７％ 。临床随访期间，Ａ 组５ 例发生心脏事件，血管造影复查，２ 例再狭窄；Ｂ１ 组仅２例发生心脏事件，造影复查２ 例均再狭窄，需再次ＰＴＣＡ；Ｂ２ 组 ５ 例发生心脏事件，３ 例造影发现再狭窄。闭塞冠脉再通未成功１６ 例中３ 例出现心脏事件，其中１ 例死亡。结论　闭塞冠脉再通成功达支架样效果或置入支架有助于改善临床预后，但部分病变存在支架置入的限制因素。Objective To determine the criterias and limitations of stent implantation for the patients with chronic total coronary artery occlusion Methods 82 patients with 82 total occluded coronary lesions underwent percutaneous transluminal angioplasty The procedure has been conducted with or without stents implantation based on the morphological results post occluded coronary artery recanalization All patients underwent 6 month clinical follow up angiography to assess the major adverse cardiac events Results Sixty six out of 82 lesions were successfully recanalized with a successful rate of 80 5% Group A: 23 lesions (34 8%) obtained a stent like results post balloon angioplasty, Group B: 43 patients have not obtaind stent like results Thus, group B 1 30 patients (45 5%) received stent implantation and group B 2 13 patients with stent implantation limitations did not receive stent implantation During the clinical follow up period In Group A 2 patients developed restenosis, in Group B 1 2 patients developed restenosis ans received angioplasty again and in Group B 2 3 patients developed restenoss Three patients without successful recanalization presented recurrence of cardiac events, one of them death Conclusion Successful recanalization with stent like results or stent implantation will benefit the clinical outcomes of the patients with total occluded coronary artery Some lesions with limitations seems not suitable for stent implantation

关 键 词：冠状动脉 完全闭塞 血管成形术 支架 

分 类 号：R654.205[医药卫生—外科学]