经皮冠状动脉腔内成形术治疗支架内再狭窄  

Management of in stent restenosis by balloon angioplasty

作　　者：胡健[1] 沈卫峰[1] 张建盛[1] 张大东[1] 张宪[1] 郑爱芳[1] 

机构地区：[1]上海第二医科大学瑞金医院心脏科,200025

出　　处：《上海医学》2000年第4期205-206,共2页Shanghai Medical Journal

摘　　要：目的　评价用经皮冠状动脉腔内成形术 (PTCA)治疗支架内再狭窄临床疗效。方法　 2 1例患者(2 4个支架 )于冠状动脉内支架术后平均 (7.3± 5 .3)个月发生支架内再狭窄 (支架节段管腔内径减小≥ 5 0 % ) ,各例均有心绞痛症状。以标准方法行PTCA治疗。结果　 2 4个支架中 ,完全阻塞 6个 ,不完全阻塞 18个。PT CA总成功率为 95 .8% ,冠状动脉最小内径由术前 (0 .5 9± 0 .46 )mm增至术后 (2 .2 9± 0 .33)mm(P <0 .0 0 1) ;狭窄程度由术前 (79± 15 ) %降至术后 (17± 4) % (P <0 .0 0 1) ,术中无严重并发症。随访 (4.6± 3.1)个月 ,16例心绞痛明显减轻或消失。结论　用PTCA治疗冠状动脉内支架术后再狭窄安全、有效。Objective To evaluate the clinical efficacy of simple balloon coronary angioplasty in the management of in stent restenosis. Methods Twenty one patients who developed in stent restenosis (24 stents) after coronary stenting [mean (7.3±5.3) months] underwent conventional balloon coronary angioplasty using a standard technique. Minimal diameter of stenotic coronary segment and degree of stenosis were measured by computer assisted quantitative coronary analysis (QCA), clinical symptoms and follow up results were recorded. Results Among 24 restenotic stents, 6 were totally occluded and 18 were subtotally occluded. The overall successful rate of the procedure was 95.8%. After balloon angioplasty, the minimal diameter of stenotic coronary segment increased from (0.59±0.46) mm to (2.29±0.33) mm, and the degree of stenosis reduced from (79±15)% to (17±4)% (all P <0.001). There were no major procedure related complications. During follow up [mean (4.6±3.1) months], the anginal symptoms were ameliorated or disappeared in 16 patients.Conclusion Balloon coronary angioplasty was safe and effective for the treatment of in stent coronary restenosis. (Shanghai Med J, 2000, 23∶205 206)

关 键 词：经皮冠状动脉腔内成形术 支架内再狭窄 PTCA 

分 类 号：R654.2[医药卫生—外科学]