张慧平,艾虎,赵迎,唐国栋,李辉,郑耐心,孙福成

• 1:北京医院心内科

摘要(Abstract)：

目的分析冠状动脉内支架断裂患者的临床、冠状动脉造影及经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)特征。方法北京医院2006年1月至2014年8月行PCI并置入支架的患者共6579例,其中2407例患者复查了冠状动脉造影,对造影证实支架断裂患者的临床和冠状动脉影像资料进行分析,并复习文献。结果经冠状动脉造影证实的支架断裂患者共6例,发现支架断裂的中位时间为398(220~2516)d。其中,前降支支架断裂1例,表现为急性心肌梗死;右冠状动脉支架断裂5例,表现为不稳定型心绞痛或无症状。5例患者断裂支架置入部位均有钙化、迂曲明显,均为非成角病变,其中4例的原发病变为右冠状动脉的慢性完全或次全闭塞。5例患者所置入支架为长支架且有支架重叠,3例在支架置入后进行了高压后扩张。5例患者为靠近支架连接处断裂,4例为支架完全断裂。支架断裂继发急性血栓形成1例,发生局限型支架内再狭窄3例,均再次置入药物洗脱支架。结论冠状动脉内支架断裂多见于右冠状动脉,与血管迂曲、置入长支架、高压后扩张及支架重叠等因素有关,多为靠近支架连接处断裂,可继发支架内再狭窄、急性支架内血栓形成。

关键词(KeyWords)： 冠状动脉;冠状动脉造影;支架;断裂

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 张慧平,艾虎,赵迎,唐国栋,李辉,郑耐心,孙福成

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