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目的:通过分析药物洗脱支架置入术后发生冠状动脉瘤病例的临床情况,探讨药物支架后发生冠状动脉瘤的机制及远期预后。方法:支架置入后5~12个月复查冠状动脉造影的患者,对比药物支架与普通支架术后冠状动脉瘤发生情况;并对发生动脉瘤的患者进行长期临床随访。结果:457例患者于支架术后5~12个月复查了冠状动脉造影,有5例随访时发现了支架部位冠状动脉瘤(4例药物支架,1例裸支架);Cypher支架、Taxus支架和裸支架后发生冠状动脉瘤的比例分别为2.13%(3/141)、0.90%(1/111)和0.49%(1/205),P>0.05;药物支架术后左前降支、左回旋支和右冠状动脉发生动脉瘤分别有2.05%(3/146)、2.08%(1/48)和0%(0/48),P>0.05。这些患者平均19个月的临床随访中没有发生任何不良事件。结论:药物支架和裸支架在不同部位发生动脉瘤情况差异无统计学意义,远期预后良好。
OBJECTIVE: To analyze the clinical situation of coronary aneurysm cases after stent implantation and discuss the mechanism and long-term prognosis of coronary aneurysms after drug stent implantation. Methods: The coronary angiography was reviewed in 5 to 12 months after stent implantation. The incidence of coronary aneurysm after drug-stent and conventional stent were compared. A long-term clinical follow-up was performed on patients with aneurysm. Results: Coronary angiography was performed in 457 patients 5 to 12 months after stent implantation. Coronary artery aneurysms at the stent site were found in 5 patients (4 drug-eluting stents and 1 bare-metal stent); Cypher stent, Taxus stent and The proportions of coronary aneurysms after stent implantation were 2.13% (3/141), 0.90% (1/111) and 0.49% (1/205), respectively, with P> 0.05. The left anterior descending coronary artery and left circumflex artery And 2.0% (3/146), 2.08% (1/48) and 0% (0/48), respectively, in the right coronary artery and P> 0.05. These patients had an average of 19 months of clinical follow-up without any adverse events. Conclusion: There was no significant difference in aneurysm between drug-stent and bare-stent in different sites, and the long-term prognosis was good.