Briguori Carlo, Sarais Cristiano, Pagnotta Paolo, Liistro Francesco, Montorfano Matteo, Chieffo Alaide, Sgura Fabio, Corvaja Nicola, Albiero Remo, Stankovic Goran, Toutoutzas Costantinos, Bonizzoni Erminio, Di Mario Carlo, Colombo Antonio
Laboratory of Interventional Cardiology, Vita e Salute University School of Medicine, San Raffaele Hospital, Milan, Italy.
J Am Coll Cardiol. 2002 Aug 7;40(3):403-9. doi: 10.1016/s0735-1097(02)01989-7.
OBJECTIVES; We sought to evaluate whether strut thickness may impact the restenosis rate after stent implantation in small coronary arteries.
Small vessel size (<3.0 mm) is an independent risk factor for the occurrence of in-stent restenosis. It has been reported that vessel damage induced during stent deployment is an important factor in restenosis.
From our database, we selected all patients who had successful stenting in small native vessels, with angiographic follow-up available, between March 1996 and April 2001. The strut was defined as thin when <0.10 mm and thick when > or = 0.10 mm. According to these criteria, we identified two subgroups: a thin group and a thick group.
A total of 821 (57%) of the 1,447 patients had angiographic follow-up available and were included in the analysis. The thin group included 400 patients with 505 lesions. The thick group included 421 patients with 436 lesions. The restenosis rate was 28.5% in the thin group and 36.6% in the thick group (p = 0.009; odds ratio [OR] 1.44, 95% confidence interval [CI] 1.09 to 1.90). The study group was classified into three subgroups according to the reference vessel diameter: < or = 2.50 mm, 2.51 to 2.75 mm and 2.76 to 2.99 mm. Strut thickness influenced the restenosis rate only in the subgroup with a reference vessel diameter between 2.76 and 2.99 mm, with rates of 23.5% in the thin group and 37% in the thick group (p = 0.006). By logistic regression analysis, predictors of restenosis were stent length (OR 1.03, 95% CI 1.01 to 1.04; p = 0.001), strut thickness (OR 1.68, 95% CI 1.23 to 2.29; p = 0.001) and diabetes mellitus (OR 2.10, 95% CI 1.21 to 3.68; p = 0.007).
This study supports that strut thickness is an independent predictor of restenosis in coronary arteries with a reference diameter of 2.75 to 2.99 mm.
目的；我们试图评估支架小梁厚度是否会影响小冠状动脉支架植入术后的再狭窄率。
小血管直径（<3.0毫米）是支架内再狭窄发生的独立危险因素。据报道，支架置入过程中引起的血管损伤是再狭窄的一个重要因素。
从我们的数据库中，我们选择了1996年3月至2001年4月期间在小的自身血管中成功进行支架置入且有血管造影随访资料的所有患者。当支架小梁厚度<0.10毫米时定义为薄，当≥0.10毫米时定义为厚。根据这些标准，我们确定了两个亚组：薄组和厚组。
1447例患者中有821例（57%）有血管造影随访资料并纳入分析。薄组包括400例患者和505处病变。厚组包括421例患者和436处病变。薄组的再狭窄率为28.5%，厚组为36.6%（p = 0.009；优势比[OR]1.44，95%置信区间[CI]1.09至1.90）。根据参照血管直径，研究组分为三个亚组：≤2.50毫米、2.51至2.75毫米和2.76至2.99毫米。支架小梁厚度仅在参照血管直径为2.76至2.99毫米的亚组中影响再狭窄率，薄组的再狭窄率为23.5%，厚组为37%（p = 0.006）。通过逻辑回归分析，再狭窄的预测因素为支架长度（OR 1.03，95% CI 1.01至1.04；p = 0.001）、支架小梁厚度（OR 1.68，95% CI 1.23至2.29；p = 0.001）和糖尿病（OR 2.10，95% CI 1.21至3.68；p = 0.007）。
本研究支持支架小梁厚度是参照直径为2.75至2.99毫米的冠状动脉再狭窄的独立预测因素。
