冠状动脉带膜支架的疗效  

Therapeutic effect of coronary stent grafts

作　　者：储光[1] 张国兵[1] 张治[1] 杨文艺[1] 戴秋艳[1] 刘少稳[1] 

机构地区：[1]上海交通大学附属第一人民医院心内科,200080

出　　处：《国际心血管病杂志》2011年第3期181-183,186,共4页International Journal of Cardiovascular Disease

摘　　要：目的：观察冠状动脉带膜支架的疗效。方法：冠状动脉带膜支架术13例，包括冠状动脉穿孔11例及冠状动脉瘤2例，观察即刻临床效果。术后双联抗血小板治疗至少1年，随访急性心肌梗死、死亡等主要心血管事件，并复查冠状动脉造影，分析支架内再狭窄及支架内血栓形成发生率。结果：11例冠状动脉穿孔的患者行带膜支架术后，10例即刻造影显示无明显造影剂外渗，临床症状缓解；1例造影仍提示造影剂大量外渗，紧急外科手术，最终死亡。2例冠状动脉瘤的患者行带膜支架术后，造影显示瘤体基本不显影。术后随访1年，未出现急性心肌梗死、死亡等主要心血管事件，6～12个月复查冠状动脉造影，发现1例支架内再狭窄，6例支架处内膜增生，未见支架内血栓形成。结论：带膜支架能有效地处理冠状动脉严重穿孔及部分冠状动脉瘤病变，即刻及近期效果良好。Objective： To assess the effect of coronary stent grafts. Methods： Thirteen patients underwent stent grafts implantation, among them eleven cases had coronary artery perforation and the other two patients had coronary artery aneurysm. The immediate clinical effects were observed. Dual- antiplatelet therapy lasted for at least 1 year after operation. Major cardiovascular events including acute myocardial infarction and death were followed up. Coronary angiography was re-performed so that the rate of stent restenosis or thrombosis was studied. Results：Among the 11 cases with coronary artery perforation, immediate coronary angiography showed no obvious leakage of contrast medium in 10 cases when stent-grafts were implanted and their symptoms were alleviated. The other one was still in the condition of mass leakage of contrast medium which resulted in emergent surgery and ultimate death. Coronary angiography showed almost no aneurysms in the two cases of coronary artery aneurysms after implantation of stent-grafts. No major cardiovascular events were observed during the 1 year follow-up period. Coronary angiography at 6-12 months showed a stent restenosis in 1, intimal hyperplasia in 6 but no stent thrombosis. Conclusion： With good immediate and short-term effects, stent grafts are competent in deal with serious coronary artery perforations and some coronary artery aneurysms.

关 键 词：冠心病 冠状动脉瘤 支架 冠状动脉造影术 

分 类 号：R541.4[医药卫生—心血管疾病]