摘要
目的探讨冠状动脉支架置入后斑块的重新分布对支架边缘的影响及此影响是否与所置入支架长度有关。方法47例行经皮冠状动脉介入治疗（PCI）的稳定性和不稳定性心绞痛患者，冠状动脉内共置入支架70枚，根据支架的长度分为两组，支架长度≤18mm和〉18mm组。于支架置入前后的支架远端边缘（支架远端5mm）、支架和支架近端边缘（支架近端5mm）进行血管内超声（IVUS）图像分析，测量冠状动脉横截面上的管腔面积（LA）、血管面积（VA）。三段分析部位的LA和VA的平均值乘以三段的长度（即5mm、支架长度和5mm）即为三段的管腔体积（LV）和血管体积（VV）。VV-LV=管壁体积（WV），支架两端移动斑块体积：支架置入后WV-支架置入前WV。结果在支架长度≤18mm组支架近远端分别检测到91％和93％斑块移位（P〉0．05），在支架长度〉18mm组支架近远端分别检测到80％和91％的斑块移位（P〈0．05）。支架置入后支架长度≤18mm组支架近远端和支架长度〉18mm组支架近端边缘，LV缩小、VV无变化、WV明显增加，即由于斑块的移位造成支架置入后即刻以上部位有明显的管腔缩小，但是支架长度〉18mm组支架远端边缘情况不同，LV和VV反而增加，WV有所增加，即在支架长度〉18mm组支架远端边缘斑块的移位并没有造成支架置入即刻管腔的缩小。结论长、短支架置入后对支架近远端边缘斑块的移位和管腔的影响不同，短支架近远端和长支架近端边缘在支架置入后有斑块的移入和管腔的缩小，而长支架远端边缘虽有斑块的移入但无管腔的缩小。
Objective To evaluate the association between poststenting atherosclerotic plaque redistribution/lumen reduction at the stent edge and stent length. Methods Seventy stents were implanted to 47 patients with stable or unstable angina and 33 stents were ≤ 18 mm and 37 stents were 〉 18 mm. Intravascular ultrasound analysis was performed on proximal stent edge, stent area and distal stent edge. Lumen area （LA） and vascular area （VA） were measured and lumen volume （LV） and vascular volume （VV） were calculated on the three segments. Vascular wall volume （WV） was calculated as VV - LV, volume of plaque redistribution = poststenting WV - prestenting WV. Results Compared to prestenting, poststenting LV significantly decreased, VV remained unchanged and WV significantly increased at proximal and distal edges of ≤18 mm group and at proximal edge of 〉 18 mm group, suggesting reduced lumen due to plaque distribution. At distal edge of 〉 18 mm group, poststenting LV, VV and WV all equally significantly increased therefore the lumen was not affected by plaque distribution. Conclusion The poststenting lumen changes due to plaque redistribution were associated with stent length, lumen reduced at proximal and distal edge of short stents and proximal edge of long stents but not at the distal edge of long stents.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2008年第6期481-484,共4页
Chinese Journal of Cardiology
关键词
超声检查
介入性
血管成形术
经腔
经皮冠状动脉
斑块移位
Ultrasonography,interventional
Angioplasty, transluminal perentaneous coronary
Plaque distribution
