评价冠状动脉内支架对冠状动脉闭塞的临床及血管造影的远期疗效The six months follow up of clinical and angiographic outcome for stenting chronic total coronary occlusion
董少红,丁明镐,赵廷馆,姜贞采
摘要(Abstract)：
目的 研究对完全闭塞的血管成功ＰＴＣＡ术后，选择性置入支架的近期及远期临床疗效及血管造影结果。方法４９８例完全血管闭塞的病人中，能成功进行ＰＴＣＡ并置入支架，完成临床及血管造影随访的８４例病人，共放置９８个支架，观察其术后近期及远期临床事件发生率及血管造影的特点。结果 置入支架后，住院期间，５％的病人出现亚急性血管闭塞，无死亡，１例发生心肌梗塞，至半年随访终点时，共有３０％的病人出现再狭窄，血管闭塞率１３％，重施血管再通术２０％，半年后的无心脏事件率为６８％。结论对完全血管闭塞病人，选择性支架术明显降低再狭窄及血管闭塞率，减少临床心脏事件的发生率。
关键词(KeyWords)： 冠脉支架; 慢性冠脉闭塞; 临床及血管造影预后
基金项目(Foundation):
作者(Author): 董少红,丁明镐,赵廷馆,姜贞采
参考文献(References)：
- 1 Favereau X, Corcos T, Guerin Y, et al. Early reocclusion after successful coronary angioplasty of chronic totalocclusion. J Am Coil Cardiol, 1995, 25: 139A.
- 2 Stewart J, Denne L, Bowker T, et al. Percutaneoustransluminal coronary angioplasty in chronic coronaryartery occlusion. J Arn Coil Cardiol, 1993,21: 1371-1376.
- 3 Berger PB, Holmes DR, ohman M, et al. Restenosis,reocclusion and adverse cardiovascular events after successful balloon angioplasty of occluded versus nonocclud- ed coronary arteries Results from the multicenter American Research trial with cilazapril after angioplasty to prevent transluminal cornary obstruction and restenosis(MARCATOR). J Am Coil Cardiol, 1996, 27: 1-7.
- 4 Violaris A, Melkert R, Serruys P, et al. long-term luminal renarrowing after successful selective coronary angioplasty of total occlusions. A quantitative angiographicanalysis. Circulation, 1995, 91: 2140-2150.
- 5 Sato Y, Nosaka H, Kimura T, et al. Randomised comparision of balloon angioplasty versus coronary stent implantation for total occlusion. J Am Coil Cardiol, 1996,27: 152A-155A.
- 6 Ozaki Y, Violaris AG, Hamburger J, et al. short andlong term clinical and quantitative angiographic resultswith new, less shortening wallstent for vessel reconstruction in chronic total occlusion: A quantitative angiographic study. J Am Coil Cardiol, 1996, 28: 354-360.
- 7 Werner GS, Grosse W, Oietrich J, et al. Morphology ofchronic total ocronary occlusions as assessed by intravascular ultrasound: implications for the interventionaltherapy [abstract]: Eur Heart J, 199b, 16 (Suppl ): 429.
- 8 Kinoshita l, Katoh O, Narlyama J, et al. Coronary angioplasty of chronical total occlusions with bridging collateral vessels: Immediate and follow up outcome from alarge single center experience. J Am Coil Cardiol, 1995,26: 409-1.