冠状动脉长支架的临床应用：急性期结果(摘要)
作者：乔树宾 高润霖 陈纪林 杨跃进 徐波 姚民 秦学文 左鲁宁 刘海波 吴永健 姚康宝
单位：北京市，中国医学科学院 中国协和医科大学 心血管病研究所；阜外心血管病医院 冠心病研究室(100037)
关键词：
中国循环杂志99zk57 目的：冠状动脉弥漫性病变经皮冠状动脉腔内成形术(PTCA)治疗的成功率低，常常伴有并发症的发生。单支血管内置入多个支架治疗费时、昂贵。本研究目的为明确冠状动脉内长支架的短期应用结果。
方法：本研究回顾性分析了我院长支架(≥30 mm)初步应用的情况。截止1999年7月20日我院共为1 032例患者置入了冠状动脉支架，其中74例患者置入了长支架。74例患者中，49例患者系稳定性心绞痛，25例患者为不稳定性心绞痛。45例患者有陈旧性心肌梗塞病史。79处病变共置入了79个长支架(5.4%)。类型包括：53个Nir支架，9个M-L支架，7个Wallstent支架，4个GRⅡ支架，1个Wiktor支架。置入支架的指征为：49个支架为选择性(DE NOVO)，19个支架由于PTCA球囊扩张结果不满意置入，4个支架为再狭窄病变置入，7个支架为紧急情况置入(其中3个支架由于出现急性闭塞置入)。
, 百拇医药
结果：冠状动脉狭窄程度由术前的(92.3±8.6)%降至术后的(1.1±3.0)%。院内并发症：2例患者术中出现支架内血栓形成，1例术中出现心室颤动，1例出现冠状动脉痉挛。无1例死亡或急诊冠状动脉旁路移植手术。故长支架的置入成功率为100%。住院期间无其它重要并发症。4例患者进行了随访冠状动脉造影，仅有1例出现支架内再狭窄。
结论：对于长的或弥漫性病变可以成功地置入长的冠状动脉支架，可以择期置入，在紧急情况下效果更佳。近期效果良好。
Clinical Use of Long Coronary Stents: Short-Term Results (Abstract)
Division of Coronary Heart Disease, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037)
, 百拇医药
Qiao Shubin, Gao Runlin, Chen Jilin, et al.
Objective: Angioplasty for long diffuse narrowing is associated with low success and high complication rates. Implantation of multiple stents in a single artery is time-consuming and too expensive.
Methods: This study was to assess the short-term results of long coronary stents. The initial experience with the use of long coronary stents (≥30 mm) was analyzed retrospectively. Until July 20, 1999, stent implantation was performed in 1 032 patients with 1 472 stents. Long coronary stents were implanted for 74 patients, which included 49 patients with stable angina, 25 patients with unstable angina. Forty-five patients had a history of OMI. Seventy-nine (5.4%) stents were deployed in 79 narrowings in 74 patients (53 Nir stents, 9 Multi-link stents, 7 Wallstents, 4 Gianturco-Roubin Ⅱ stents, and 1 Wiktor stent). Indications for stenting were as following: 49 stents as de novo stenting, 19 stents for subopitimal results, 4 stents for restenotic lesions, 7 stents for “bail-out” (including 3 stents for abrupt occlusion). Average length of stent was 33.3±3.7 mm.
, 百拇医药
Results: Stenosis before the procedure was (92.3±8.6)%, decreased to (1.1±3.0)% after stenting. The complications during procedure included 2 patients with in-stent thrombosis, 1 with VF, 1 with coronary spasm. There was no death or emergency CABG. Success rate was 100% for implantation of long coronary stents. There were no other major complications during the hospital course. At follow-up, angiography was done for 4 patients, only one patient showed in-stent restenosis.
Conclusion: Long coronary stent can be deployed successfully for long or diffuse lesions. They are useful for elective implantation and extremely helpful in bail-out situations. The immediate results were excellent., 百拇医药
单位：北京市，中国医学科学院 中国协和医科大学 心血管病研究所；阜外心血管病医院 冠心病研究室(100037)
关键词：
中国循环杂志99zk57 目的：冠状动脉弥漫性病变经皮冠状动脉腔内成形术(PTCA)治疗的成功率低，常常伴有并发症的发生。单支血管内置入多个支架治疗费时、昂贵。本研究目的为明确冠状动脉内长支架的短期应用结果。
方法：本研究回顾性分析了我院长支架(≥30 mm)初步应用的情况。截止1999年7月20日我院共为1 032例患者置入了冠状动脉支架，其中74例患者置入了长支架。74例患者中，49例患者系稳定性心绞痛，25例患者为不稳定性心绞痛。45例患者有陈旧性心肌梗塞病史。79处病变共置入了79个长支架(5.4%)。类型包括：53个Nir支架，9个M-L支架，7个Wallstent支架，4个GRⅡ支架，1个Wiktor支架。置入支架的指征为：49个支架为选择性(DE NOVO)，19个支架由于PTCA球囊扩张结果不满意置入，4个支架为再狭窄病变置入，7个支架为紧急情况置入(其中3个支架由于出现急性闭塞置入)。
, 百拇医药
结果：冠状动脉狭窄程度由术前的(92.3±8.6)%降至术后的(1.1±3.0)%。院内并发症：2例患者术中出现支架内血栓形成，1例术中出现心室颤动，1例出现冠状动脉痉挛。无1例死亡或急诊冠状动脉旁路移植手术。故长支架的置入成功率为100%。住院期间无其它重要并发症。4例患者进行了随访冠状动脉造影，仅有1例出现支架内再狭窄。
结论：对于长的或弥漫性病变可以成功地置入长的冠状动脉支架，可以择期置入，在紧急情况下效果更佳。近期效果良好。
Clinical Use of Long Coronary Stents: Short-Term Results (Abstract)
Division of Coronary Heart Disease, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037)
, 百拇医药
Qiao Shubin, Gao Runlin, Chen Jilin, et al.
Objective: Angioplasty for long diffuse narrowing is associated with low success and high complication rates. Implantation of multiple stents in a single artery is time-consuming and too expensive.
Methods: This study was to assess the short-term results of long coronary stents. The initial experience with the use of long coronary stents (≥30 mm) was analyzed retrospectively. Until July 20, 1999, stent implantation was performed in 1 032 patients with 1 472 stents. Long coronary stents were implanted for 74 patients, which included 49 patients with stable angina, 25 patients with unstable angina. Forty-five patients had a history of OMI. Seventy-nine (5.4%) stents were deployed in 79 narrowings in 74 patients (53 Nir stents, 9 Multi-link stents, 7 Wallstents, 4 Gianturco-Roubin Ⅱ stents, and 1 Wiktor stent). Indications for stenting were as following: 49 stents as de novo stenting, 19 stents for subopitimal results, 4 stents for restenotic lesions, 7 stents for “bail-out” (including 3 stents for abrupt occlusion). Average length of stent was 33.3±3.7 mm.
, 百拇医药
Results: Stenosis before the procedure was (92.3±8.6)%, decreased to (1.1±3.0)% after stenting. The complications during procedure included 2 patients with in-stent thrombosis, 1 with VF, 1 with coronary spasm. There was no death or emergency CABG. Success rate was 100% for implantation of long coronary stents. There were no other major complications during the hospital course. At follow-up, angiography was done for 4 patients, only one patient showed in-stent restenosis.
Conclusion: Long coronary stent can be deployed successfully for long or diffuse lesions. They are useful for elective implantation and extremely helpful in bail-out situations. The immediate results were excellent., 百拇医药