论文部分内容阅读
目的:应用光学相干断层成像(OCT)评价冠状动脉内支架术后即刻支架周围组织结构改变。方法:对21例临床诊断冠心病准备介入治疗患者,在冠状动脉内置入支架后即刻进行OCT成像检查。21例患者中共有22支冠状动脉置入25个支架,其中前降支11支13个支架,回旋支8支9个支架,右冠状动脉3支3个支架。OCT评价支架贴壁不良、血管夹层及撕裂、组织脱垂等。支架贴壁不良定义为支架支撑杆与血管壁距离大于0.20mm,组织脱垂定义为血管壁组织通过支架网眼突入管腔。结果:21例患者均成功进行OCT检查,22支靶血管25个支架均成功获得清晰OCT图像。通过OCT发现置入的25个支架中有12个支架可以看到部分支架支撑杆未能完全封闭血管壁上的夹层及撕裂;所置入的支架中有50个支架支撑杆贴壁不良,平均支架支撑杆与血管壁的距离为0.39±0.20(0.20~1.16)mm。通过OCT检出置入的25个支架中有20个支架可见到不同程度组织脱垂,共检出85个组织脱垂,平均最大组织脱垂面积为0.55±0.64(0.04~2.81)mm2。结论:OCT成像技术可清晰显示冠心病冠状动脉支架后血管夹层、撕裂组织脱垂及支架贴壁情况,其临床意义有待于进一步研究。
OBJECTIVE: To evaluate the changes of the tissue structure around the stent immediately after coronary stenting using optical coherence tomography (OCT). Methods: Twenty-one patients with clinically diagnosed CHD were enrolled in this study. OCT imaging was performed immediately after the stent was placed in the coronary artery. Twenty-one of the 21 patients had a total of 25 stents placed in the coronary arteries, including 11 anterior descending branches, 13 stents, 8 revolving branches, 9 stents, and 3 right stents. OCT evaluation scaffold adherent dysplasia, vascular dissection and tear, tissue prolapse and so on. Adherence of the stent is defined as stent struts and vascular wall distance greater than 0.20mm, tissue prolapse is defined as vascular wall tissue through the stent mesh into the lumen. Results: Twenty-one patients underwent OCT successfully, and all 25 scaffolds of target vessel successfully acquired clear OCT images. OCT found that there are 12 stents placed in 25 stent can see some stents support rod failed to completely close the dissection and tear on the vessel wall; 50 stents placed in the bracket poor adhesion, The mean stent-to-vessel wall distance was 0.39 ± 0.20 (0.20 to 1.16) mm. Twenty of the 25 scaffolds examined by OCT showed different degrees of tissue prolapse. Totally 85 tissue prolapse were detected, and the average maximum area of tissue prolapse was 0.55 ± 0.64 (0.04 ~ 2.81) mm 2. Conclusion: OCT imaging can clearly show the status of vascular dissection, tissue prolapse and scaffold attachment after coronary stent implantation in coronary heart disease. The clinical significance remains to be further studied.