连续血管内超声评价完全可降解聚-L-乳酸支架置入猪冠状动脉1个月支架弹性回缩Consecutive IVUS assessment of acute recoil of fully bioabsorbable poly-L-lactic acid scaffold within 1 month in porcine model
吴轶喆,葛雷,沈雳,王齐兵,钱菊英,谢建,胡玺,葛均波
摘要(Abstract):
目的评价完全可降解聚-L-乳酸(PLLA)支架置入猪冠状动脉1月内早期支架弹性回缩。方法将XINSORB支架(XINSORB组)和EXCEL支架(EXCEL组)随机置入小型猪冠状动脉内,术后即刻、2 h、4 h和6 h行造影和血管内超声(IVUS)检查,术后4周复查IVUS。早期支架直径弹性回缩量定义为支架释放时球囊平均直径分别与支架术后即刻、2 h、4 h和6 h支架置入部位直径之差。早期支架直径弹性回缩百分数定义为支架直径弹性回缩量与球囊平均直径的比值,以百分数表示。早期支架面积弹性回缩量定义为术后即刻IVUS所测量的支架平均面积分别与术后2、4、6 h及术后4周时支架平均面积之差。早期支架面积弹性回缩百分数定义为支架平均面积弹性回缩量与术后即刻支架平均面积的比值,以百分数表示。结果 16头小型猪共置入32枚支架(XINSORB组16枚,EXCEL组16枚)。XINSORB组术后即刻、2 h、4 h和6 h支架直径弹性回缩量和百分数分别为(0.05±0.06)mm、(1.72±1.78)%,(0.10±0.07)mm、(3.34±2.43)%,(0.08±0.06)mm、(2.59±1.89)%和(0.09±0.05)mm、(2.99±1.69)%。EXCEL组不同时间点该两项指标分别为(0.02±0.06)mm、(0.58±2.02)%,(0.06±0.10)mm、(2.17±3.30)%,(0.07±0.08)mm、(2.19±2.72)%和(0.07±0.09)mm、(2.41±2.76)%。XINSORB组术后2 h、4 h、6 h和4周支架面积弹性回缩量和百分数分别为(0.05±0.13)mm2、(0.62±1.90)%,(0.04±0.35)mm2、(0.29±4.95)%,(0.22±0.46)mm2、(2.87±6.65)%和(0.31±0.27)mm2、(4.30±3.66)%。EXCEL组不同时间点该两项指标分别为(0.01±0.11)mm2、(0.04±1.59)%,(-0.03±0.36)mm2、(-0.44±5.34)%,(0.08±0.23)mm2、(1.02±3.41)%和(0.10±0.22)mm2、(1.44±3.35)%。不论是造影还是IVUS随访,两组支架均未发生明显弹性回缩,且弹性回缩程度相似。不同时间点IVUS均未发现支架贴壁不良征象。结论完全可降解XINSORB支架和EXCEL支架置入猪冠状动脉1月内,造影和IVUS随访未发现显著的支架弹性回缩,两组支架弹性回缩程度相似。两组支架均未见支架贴壁不良征象。
关键词(KeyWords): 血管成形术,经腔,经皮冠状动脉;超声检查,介入性;冠状血管;猪
基金项目(Foundation): 上海市科委科技创新行动计划(11441900300);; 上海市科委纳米科技项目(11nm0504900);; 教育部高等学校博士学科点专项科研基金(20110071110053)
作者(Author): 吴轶喆,葛雷,沈雳,王齐兵,钱菊英,谢建,胡玺,葛均波
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