摘要
目的:评价支架内再狭窄(ISR)病变再次行介入治疗后的造影复查结果,试图寻找合适的治疗方法。方法:行冠状动脉再狭窄病变介入治疗后进行冠状动脉造影复查的患者58例,分析其临床资料及冠状动脉造影图像。根据再次介入治疗方法不同分为置入药物支架(DES)和非DES治疗(包括单纯球囊扩张、双导丝球囊或切割球囊扩张、放射治疗和裸支架置入)组,分析再狭窄率及主要心血管不良事件(MACE)发生情况。结果:共涉及58处ISR病变,前降支病变占56.90%;70.69%为裸支架的ISR病变;32.76%的病变为支架内局限性狭窄,支架内弥漫性狭窄病变占18.97%,10.24%为支架完全闭塞病变;其中50%的ISR患者接受了病变处DES治疗,20.69%接受了单纯的普通球囊扩张;复查造影时间为平均(13.12±8.03)个月;ISR病变DES组发生病变处再狭窄和发生MACE情况明显低于接受其他治疗组(再狭窄发生率17.24%:51.72%,P<0.05;MACE发生率20.69%:51.72%,P<0.05);对有可能影响ISR病变介入治疗后再次发生ISR的各种因素进行Logistic分析可见,再次治疗的方法是再次发生ISR的独立危险因素。结论:对于ISR病变置入DES近中期效果明显优于其他介入治疗方法。
Objective：To evaluate the outcomes of patients who underwent repeat intracoronary interventional therapy for in-stent restenosis （ISR）. Method：Patients who performed interventional therapy for ISR and had angiographic follow-up from January 2000 to June 2007 were included in this study. According to the different treatment methods, the patients classified into two groups （DES group and non-DES group）. Non-DES therapies included BMS （bare metal stent） implantation, intracoronary brachytherapy, monorail balloon, cutting balloon or safecut balloon angioplasty therapies. The clinical and angiographic outcomes between two groups were analyzed and compared. Result：This study included 58 lesions. Among them, 56.90% were LAD lesions; 70.69% were restenosis lesion in BMS; 32.76% were focal restenosis lesion, 18.97% were diffuse lesion in stent, 10. 24% were total occlusion lesion; 50% lesions were implanted DES, 20.69% were performed just monorail balloon angioplasty. Angiographic follow up were performed after 13.12±8.03 monthes. Between the two different therapy methods group , there were significant difference in restenosis rate （ non - DES group vs DES group , 5 1 . 7 2 % vs 17.24%, P=0. 006） and MACE rate （51.72% vs 20.69%, P=0. 014） after ISR re-interventional treatments. Conclusion：The effect of DES for ISR lesions is better than other interventional methods.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2008年第5期335-338,共4页
Journal of Clinical Cardiology
