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预装球囊扩张式蛇形支架的首次临床经验:急性血管造影及中期临床结果

First clinical experience with the premounted balloon-expandable serpentine stent: acute angiographic and intermediate-term clinical results.

作者信息

Gruberg L, Grenadier E, Miller H, Peled B, Roguin A, Markiewicz W, Beyar R

机构信息

Division of Invasive Cardiology, Rambam Medical Center, the Heart System Research Center, Technion-Israel Institute of Technology, Haifa.

出版信息

Catheter Cardiovasc Interv. 1999 Feb;46(2):249-53. doi: 10.1002/(SICI)1522-726X(199902)46:2<249::AID-CCD28>3.0.CO;2-O.

Abstract

The beStent-Artist coronary stent is a newly developed, stainless steel coronary stent with a serpentine tubular design and terminal stent markers, premounted on a semicompliant balloon. During this pilot evaluation we aimed to test the acute clinical and angiographic results, short-term (30 days) and 6-month clinical results. A total of 57 stents were used to treat 43 lesions in 40 patients. Deployment strategy included predilatation, stent deployment, balloon repositioning to match the distal end of the balloon to the distal stent marker, and subsequent 12-14 atm postdilatation. There were two cases of stent dislodgment, but no procedural complications. In four cases, stent recrossing with another balloon was necessary. In two of these cases, distal dissections were observed and treated with another stent. The minimal lumen diameter (MLD) increased from 0.84+/0.52 mm at baseline to 2.7+/-0.62 mm at the end of the procedure (a corresponding decrease in diameter stenosis from 78.6 > 16.4 to 18.2+/-10.7%). The acute gain was 1.89+/-0.61mm. No adverse events occurred by 30 days. During six months, 7/40 (18.5%) of patients required target vessel revascularization due to in-stent restenosis. In summary, the premounted beStent-Artist can be delivered and deployed with favorable immediate results and high success rate with favorable long-term recurrent event rates.

摘要

beStent-Artist冠状动脉支架是一种新开发的不锈钢冠状动脉支架,具有蛇形管状设计和末端支架标记,预先安装在半顺应性球囊上。在这项初步评估中,我们旨在测试急性临床和血管造影结果、短期(30天)和6个月的临床结果。总共使用了57个支架来治疗40例患者的43处病变。植入策略包括预扩张、支架植入、将球囊重新定位以使球囊远端与支架远端标记匹配,以及随后12 - 14个大气压的后扩张。有2例支架移位,但无手术并发症。在4例病例中,需要用另一个球囊重新穿过支架。在其中2例病例中,观察到远端夹层并用另一个支架进行了治疗。最小管腔直径(MLD)从基线时的0.84±0.52毫米增加到手术结束时的2.7±0.62毫米(直径狭窄相应地从78.6%降至16.4%,再降至18.2±10.7%)。急性增益为1.89±0.61毫米。30天内未发生不良事件。在6个月期间,40例患者中有7例(18.5%)因支架内再狭窄需要进行靶血管血运重建。总之,预先安装的beStent-Artist支架能够成功植入并取得良好的即刻效果,长期复发事件发生率较低。

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