直接冠状动脉内支架置入术治疗急性心肌梗死Direct coronary stenting without predilatation in acute myocardial infarction
王伟民,赵红,陈步星,卢明瑜,刘健,吴淳,赵明中,刘喜荣
摘要(Abstract):
目的 观察急性心肌梗死 (AMI)时行无球囊预扩张直接置入冠状动脉内支架治疗的临床效果。方法 对 2 2例AMI患者在发病 12小时内 ,未经球囊预扩张而直接置入冠状动脉内支架。梗死相关血管 (IRA) (共 2 2支血管 ) ,左前降支 12例 (5 4 5 % ) ,左回旋支 5例 (2 2 7% ) ,右冠状动脉 5例 (2 2 7% )。心肌梗死溶栓试验 (TIMI)血流 1级 5例 (2 2 7% ) ,2级 13例 (5 9 1% ) ,3级 4例 (18 2 % )。结果 2 2例患者共置入 2 2个支架 ,支架置入后TIMI血流 3级 2 1例 (95 5 % ) ,2级 1例 (4 5 % ) ,残余狭窄为 3 2± 2 9% ,支架置入成功率 10 0 %。住院期间无一例死亡、再次心肌梗死及再次靶病变需重复再通治疗。结论 急性心血肌梗死 (AMI)时行无球囊预扩张直接置入冠状动脉内支架治疗 ,成功率高、并发症少 ,TIMI血流 3级达到率高
关键词(KeyWords): 心肌梗死;直接;冠状动脉;支架
基金项目(Foundation):
作者(Author): 王伟民,赵红,陈步星,卢明瑜,刘健,吴淳,赵明中,刘喜荣
参考文献(References):
- 1ParkSW ,ParkSJ,HongMK ,etal.IntracoronarystentinginPatientwithacutemyocardialinfarction.JACC ,1997,29(SupplA):456A .
- 2BrodieBR ,CrineCL ,IvanhoeR ,etal.Six monthclinicalandangiographicfollow upafterdirectangioplastyforacutemyocardialinfarction.Finalresultsfromtheprimaryangioplastyregistry[J].Circulation,1994,25:156162.
- 3StoneGW ,BrodieBr,GriffinJJ ,etal.Prospective,multicenterstudyoftheSafetyandfeasibilityofPrimarystentinginacutemyocardialinfarction:in hospitaland30 dayresultsofthePAMIstentpilottrial[IJ].JAmCallCardiol,1998,31;2330.
- 4FeedM ,NeilWWApproachtothehigh riskPatient.In:RobinGS ,CaliffRM ,O′NeillWW ,etal.eds.InterventionalCardiovascularMedicine.PrinciplesandPractice.NewYork:ChurchillLiving stone,1994,293319.
- 5PentousisD ,GuerinY ,FunckF ,etal.DirectstentimplantationwithoutPredilatationusingtheMultilinkstent.AmJCardiol,1998,82:14371440.