Göttman D, Strecker E P, Boos I, Vetter S
Abteilung für Röntgendiagnostik und Nuklearmedizin, Ev. Diakonissenkrankenhaus Karlsruhe.
Rofo. 1999 Jan;170(1):84-8. doi: 10.1055/s-2007-1011012.
In clinical prospective trials, we examined the effect of the low molecular weight heparin (lmwh) reviparin on restenosis rate after Strecker stent implantation in femoral popliteal arteries.
62 patients were treated between 1992 and 1998. Patients received reviparin, 3500 IU, prior to stent implantation followed by 7500 IU for 24 h (i.v.) and 2 x 1750 IU/day s.c. over three weeks (n = 12) or 10,500 IU for 24 h (i.v.) and 2 x 3500 IU/day s.c. over 3 1/2 weeks (n = 50). Follow-up parameters were clinical symptoms, ankle-brachial index, color Doppler flow duplex sonography, and DSA.
Three thrombotic occlusions and three stenoses were observed in the low-dose group. Raising the dose resulted in neither thrombotic nor other events within the first three months. Seven stenoses occurred afterwards up to the 7th month. The complication rate was low: one moderate hematoma and one puncture aneurysm. Primary patency rate was 88% and 80% for one and two years, respectively. This is significantly better than the primary patency rates for patients receiving low-dose lmwh (p < 0.005) or unfractionated heparin (p < 0.05).
Hence, high-dose administration of the lmwh reviparin lowers the restenosis rate after stent implantation in femoropopliteal arteries.
在临床前瞻性试验中，我们研究了低分子量肝素（lmwh）瑞肝素对股腘动脉植入施特雷克支架后再狭窄率的影响。
1992年至1998年间对62例患者进行了治疗。患者在支架植入前接受3500国际单位的瑞肝素，随后24小时静脉注射7500国际单位，并在三周内每天皮下注射2×1750国际单位（n = 12），或24小时静脉注射10500国际单位，并在3.5周内每天皮下注射2×3500国际单位（n = 50）。随访参数包括临床症状、踝肱指数、彩色多普勒血流双功超声检查和数字减影血管造影（DSA）。
低剂量组观察到3例血栓闭塞和3例狭窄。增加剂量在最初三个月内既未导致血栓形成也未引发其他事件。此后至第7个月出现7例狭窄。并发症发生率较低：1例中度血肿和1例穿刺动脉瘤。1年和2年的原发性通畅率分别为88%和80%。这明显优于接受低剂量低分子量肝素（p < 0.005）或普通肝素（p < 0.05）的患者的原发性通畅率。
因此，高剂量施用低分子量肝素瑞肝素可降低股腘动脉支架植入后的再狭窄率。
