冠状动脉支架再狭窄26例分析(摘要)
作者：周旭晨 方唯一 朱皓 郑晓群 旅朝霞
单位：辽宁省大连市，大连医科大学附属第一医院 心内科(116011)
关键词：
中国循环杂志99zk73 目的：探讨影响冠状动脉(冠脉)支架术预后的因素。
方法：观察我院自1996年5月～1999年6月行冠脉支架术的330例患者临床特点。
结果：应用支架：Nir,ACS MultiLink,Wiktor i,B-Stent,XT-stent,Jo-Stent,Cross Flex,J-J stent,AVE GFX,Cook JR-II等共10种支架。临床上出现胸痛复发，造影证实再狭窄26例，病变33处。再狭窄发生率7.8%(26/330)。临床再狭窄表现：胸痛复发：26例(7.8%),左心衰5例(1.5%),死亡4例(1.2%)。反复两次再狭窄者4例。再狭窄距前次经皮冠状动脉腔内成形术(PTCA)时间78±56天。再狭窄临床危险因子：26例患者CHOL 226±35 mg/dl vs.术后218±25 mg/dl(P>0.05),高脂血症未得到良好控制。糖尿病组与非糖尿病组对比，再狭窄率无明显差异。支架前病变危险因子：完全性闭塞病变18处(60%),长病变5处(14%),血栓性病变6处(15%)。支架结果：长支架(25～32 mm),16处(66%),2.5 mm直径支架2处(6.3%)。支架类型：XT支架15处(60%),Wiktor i 8处(25%),Nir 6处(15%),B-stent 1处(3%),Jo-stent 1处(3%),Cross Flex 1处(3%),ACS MultiLink 1处(3%)。影像学再狭窄表现，支架内再狭窄18处，支架入、出口再狭窄12处。再狭窄处理方法：单纯球囊扩张19例，支架再置入8例，切割球囊3例，CABG 1例。
, http://www.100md.com
结论：长支架是支架再狭窄的危险因素，闭塞性病变易导致再狭窄发生。XT支架再狭窄发生率较高。糖尿病不是支架再狭窄的危险因子。支架后左心衰发生可能提示再狭窄发生。支架后应当加强对高脂血症的控制。可采用球囊扩张、切割球囊、再支架等方法治疗再狭窄。
Coronary Artery Stenting Restenosis: 26 Cases Reports (Abstract)
Department of Cardiolgoy, The First Affiliated Hospital of Dalian Medical University, Dalian (116011), Liaoning
Zhou Xuchen, Fang Weiyi, Zhu Hao, et al.
Objective: To investigate the factors effecting the prognosis of intra coronary stenting.
, 百拇医药
Methods: Three hundred thirty cases of coronary stenting performed from May, 1996 to June, 1999 were analyzed clinically.
Results: The stents are as follows: Nir,ACS MultiLink,Wiktor i,B-Stent,XT-stent,Jo-Stent,Cross Flex,J-J stent,AVE GFX,Cook JR-II. The clinical manifestations of restenosis are reoccurence of chest pain (26/330, 7.8%), left heart failure (5/330, 1.5%), and death (4/330, 1.2%). Restenosis occured more than 2 times in 4 patients. The time of restenosis occured at 78±56 days from the first coronary stenting. The clinical restenosis risk factor CHOL is 226±35 mg/dl pre-stenting vs. 218±25 mg/dl after stenting. The restenosis rate is not clearly changed in diabetes mellitus patients group comparing with non diabetes mellitus patients group. The coronary artery angiographic results in 26 cases showed that 33 restenotic lesion existed, total occlusion lesion 18 (60%), diffused long lesion 5 (14%), and thrombostic lesion 6 (15%). 16 lesion were made by long stents ranged from 25 mm to 32 mm and 2 lesions resulted from small vessel stenting (25 mm). The restenosis rate in implanted stents is as follows: XT stents in 15 lesions (60%), Wiktor I 8 lesions (25%), Nir 6 lesions (15%), and B-stent, Jo-stent, Cross Flex, ACS MultiLink 1 lesion (3%) respectively. Coronary angiograghy results also showed that the 18 restenosis happened in the body of stents, 12 in the inlet or outlet of stented sites. 19 cases were treated by the balloon dilatation method, restented in 8 cases, and cutting balloon in 3 cases.
Conclusion: Long stents, the total occlusion lesion may be the risk factors of restenosis. XT stent has a rather high restenosis rate in all of the 10 sorts of stents. Diabetes mellitus is not the clinical restenosis risk factor. The balloon dilatation, restenting, and cutting balloon may be the best methods to treat restenosis lesions., 百拇医药
单位：辽宁省大连市，大连医科大学附属第一医院 心内科(116011)
关键词：
中国循环杂志99zk73 目的：探讨影响冠状动脉(冠脉)支架术预后的因素。
方法：观察我院自1996年5月～1999年6月行冠脉支架术的330例患者临床特点。
结果：应用支架：Nir,ACS MultiLink,Wiktor i,B-Stent,XT-stent,Jo-Stent,Cross Flex,J-J stent,AVE GFX,Cook JR-II等共10种支架。临床上出现胸痛复发，造影证实再狭窄26例，病变33处。再狭窄发生率7.8%(26/330)。临床再狭窄表现：胸痛复发：26例(7.8%),左心衰5例(1.5%),死亡4例(1.2%)。反复两次再狭窄者4例。再狭窄距前次经皮冠状动脉腔内成形术(PTCA)时间78±56天。再狭窄临床危险因子：26例患者CHOL 226±35 mg/dl vs.术后218±25 mg/dl(P>0.05),高脂血症未得到良好控制。糖尿病组与非糖尿病组对比，再狭窄率无明显差异。支架前病变危险因子：完全性闭塞病变18处(60%),长病变5处(14%),血栓性病变6处(15%)。支架结果：长支架(25～32 mm),16处(66%),2.5 mm直径支架2处(6.3%)。支架类型：XT支架15处(60%),Wiktor i 8处(25%),Nir 6处(15%),B-stent 1处(3%),Jo-stent 1处(3%),Cross Flex 1处(3%),ACS MultiLink 1处(3%)。影像学再狭窄表现，支架内再狭窄18处，支架入、出口再狭窄12处。再狭窄处理方法：单纯球囊扩张19例，支架再置入8例，切割球囊3例，CABG 1例。
, http://www.100md.com
结论：长支架是支架再狭窄的危险因素，闭塞性病变易导致再狭窄发生。XT支架再狭窄发生率较高。糖尿病不是支架再狭窄的危险因子。支架后左心衰发生可能提示再狭窄发生。支架后应当加强对高脂血症的控制。可采用球囊扩张、切割球囊、再支架等方法治疗再狭窄。
Coronary Artery Stenting Restenosis: 26 Cases Reports (Abstract)
Department of Cardiolgoy, The First Affiliated Hospital of Dalian Medical University, Dalian (116011), Liaoning
Zhou Xuchen, Fang Weiyi, Zhu Hao, et al.
Objective: To investigate the factors effecting the prognosis of intra coronary stenting.
, 百拇医药
Methods: Three hundred thirty cases of coronary stenting performed from May, 1996 to June, 1999 were analyzed clinically.
Results: The stents are as follows: Nir,ACS MultiLink,Wiktor i,B-Stent,XT-stent,Jo-Stent,Cross Flex,J-J stent,AVE GFX,Cook JR-II. The clinical manifestations of restenosis are reoccurence of chest pain (26/330, 7.8%), left heart failure (5/330, 1.5%), and death (4/330, 1.2%). Restenosis occured more than 2 times in 4 patients. The time of restenosis occured at 78±56 days from the first coronary stenting. The clinical restenosis risk factor CHOL is 226±35 mg/dl pre-stenting vs. 218±25 mg/dl after stenting. The restenosis rate is not clearly changed in diabetes mellitus patients group comparing with non diabetes mellitus patients group. The coronary artery angiographic results in 26 cases showed that 33 restenotic lesion existed, total occlusion lesion 18 (60%), diffused long lesion 5 (14%), and thrombostic lesion 6 (15%). 16 lesion were made by long stents ranged from 25 mm to 32 mm and 2 lesions resulted from small vessel stenting (25 mm). The restenosis rate in implanted stents is as follows: XT stents in 15 lesions (60%), Wiktor I 8 lesions (25%), Nir 6 lesions (15%), and B-stent, Jo-stent, Cross Flex, ACS MultiLink 1 lesion (3%) respectively. Coronary angiograghy results also showed that the 18 restenosis happened in the body of stents, 12 in the inlet or outlet of stented sites. 19 cases were treated by the balloon dilatation method, restented in 8 cases, and cutting balloon in 3 cases.
Conclusion: Long stents, the total occlusion lesion may be the risk factors of restenosis. XT stent has a rather high restenosis rate in all of the 10 sorts of stents. Diabetes mellitus is not the clinical restenosis risk factor. The balloon dilatation, restenting, and cutting balloon may be the best methods to treat restenosis lesions., 百拇医药