雷帕霉素洗脱支架临床应用1年随访.DOCVIP

临床医学论文-雷帕霉素洗脱支架临床应用1年随访 ???????????? 作者：赵慧强，贾国良，郭文怡，王海昌，李伟杰，栾荣华，吕安林，李成祥，李虎，王晓燕 【关键词】? 冠状动脉疾病 ?　　【Abstract】 AIM:? To investigate the efficacy and safety of rapamycin eluting stents (CypherTM) during 1year followup. METHODS:? The immediate angiographic and clinical followup outcomes were analyzed retrospectively in 112 patients who had received CypherTM. RESULTS:?One hundred and seventythree lesions were treated and 227 stents were implanted in the 112 patients. One hundred and fiftynine slow release rapamycin eluting stents were implanted in 132 lesions. The CypherTM stents were successfully implanted in 156/159 lesions (98.1%). High pressure balloon was used for stent deployment in 2?lesions with severe calcification. Dissection occurred at the distal side of stent in 1 lesion. No serious complications were found during operation and hospitalization. Clinical followup of 102 patients was conducted for 12 months and 1 patient died of cardiac death and angina pectoris occurred in 10 patients. Angiography was conducted again in the all 10 patients, and 6 restenosis in bare stents and 4 new lesions in other coronary arteries were found. Angiography was performed for a second time in 30 of 112 followedup patients, showing only 1 restenosis in CypherTM stent. CONCLUSION:? CypherTM is safe and effective in the treatment of coronary lesions. 　　【Keywords】?? sirolimus;? stents;? coronary?? disease 　　【摘要】 目的： 评价雷帕霉素洗脱支架（CypherTM）1 a的安全性及有效性. 方法： 回顾分析112例接受CypherTM支架置入术冠心病患者的即刻疗效和临床随访结果. 结果： 共处理112例患者173处病变，置入支架227枚，其中132处病变置入159枚CypherTM支架. 除2处严重钙化病变需辅以高压球囊才能充分扩张，1处支架近端发生内膜撕裂，其余全部成功置入. 手术过程及住院期间无严重并发症发生，成功率98.1%. 112例患者中102例得到随诊,平均随访1 a（≥12 mo），1例死亡，10例患者心绞痛再发，其中，6例为普通金属支架内的再狭窄（6例中1例伴CypherTM支架内近端再狭窄），4例为其他分支的新病变. 30例复查了冠状动脉造影，1例CypherTM支架内近端再狭窄. 结论： CypherTM支架临床应用安全，能显著降低再狭窄率. 　　【关键词】? 西罗莫司；支架；冠状动脉疾病 　　0引言 　　经皮冠状动脉介入治疗（Percutaneous coronary intervention, PCI）是目前治疗冠心病最有效的非手术方法，冠状动脉内支架的应用，使术后3~6 mo的再狭窄率自单纯PTCA时代的30%~50%降至20%~30%，但支架内再狭窄难以防治. 现在发展成熟的药物洗脱支架为解决这一难题带来了新的希望，目前冠心病