直接冠状动脉内支架置入术治疗急性心肌梗死  

Direct coronary stenting without predilatation in acute myocardial infarction

作　　者：王伟民[1] 赵红[1] 陈步星[1] 卢明瑜[1] 刘健[1] 吴淳[1] 赵明中[1] 刘喜荣[1] 

机构地区：[1]北京大学人民医院心内科,北京100044

出　　处：《中国介入心脏病学杂志》2001年第B12期3-5,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的　观察急性心肌梗死 (AMI)时行无球囊预扩张直接置入冠状动脉内支架治疗的临床效果。方法　对 2 2例AMI患者在发病 12小时内 ,未经球囊预扩张而直接置入冠状动脉内支架。梗死相关血管 (IRA) (共 2 2支血管 ) ,左前降支 12例 (5 4 5 % ) ,左回旋支 5例 (2 2 7% ) ,右冠状动脉 5例 (2 2 7% )。心肌梗死溶栓试验 (TIMI)血流 1级 5例 (2 2 7% ) ,2级 13例 (5 9 1% ) ,3级 4例 (18 2 % )。结果　 2 2例患者共置入 2 2个支架 ,支架置入后TIMI血流 3级 2 1例 (95 5 % ) ,2级 1例 (4 5 % ) ,残余狭窄为 3 2± 2 9% ,支架置入成功率 10 0 %。住院期间无一例死亡、再次心肌梗死及再次靶病变需重复再通治疗。结论　急性心血肌梗死 (AMI)时行无球囊预扩张直接置入冠状动脉内支架治疗 ,成功率高、并发症少 ,TIMI血流Objective To evaluate the clinical effectiveness of direct coronary stenting without predilatation in acute myocardial infarction (AMI) Methods Intracoronary stent was directly deployed without ballon predilation in 22 patients within 12 hours from onset Single vessel disease was in 12 patients (54 5%),double vessel disease in 4 patients(18 2%) and triple vessel disease in 6 patients(27 3%) Infarct related arteries (IRA) were left anterior descending artery in 12 patients (54 5%), left circumflex in 5 patients (22 7%), right coronary artery in 5 patients (22 7%) Thrombolysis in myocardial infarction TIMI 1 flow in 5 patients (22 7%), TIMI 2 flow in 13 patients (59 1%) TIMI 3 flow in 4 patients (18 2%) Results Twenty two stents were implanted (1 stent/patient) Post stenting residual stenosis decreased to 3 2±2 9%, stent deployment was successful in 100% of the cases, There were no complications, no death, no Q wave or non Q wave myocardial infarction and no repeated recanalizations during the hospitalization Conclusion Direct coronary stenting without predilatation can be performed in AMI with its high successful rate and low complication

关 键 词：心肌梗死 直接 冠状动脉 支架 治疗 

分 类 号：R542.220.5[医药卫生—心血管疾病]