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停用抗血小板治疗后药物洗脱冠状动脉支架的晚期血栓形成。

Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy.

作者信息

McFadden Eugène P, Stabile Eugenio, Regar Evelyn, Cheneau Edouard, Ong Andrew T L, Kinnaird Timothy, Suddath William O, Weissman Neil J, Torguson Rebecca, Kent Kenneth M, Pichard August D, Satler Lowell F, Waksman Ron, Serruys Patrick W

机构信息

Thoraxcenter, Erasmus University, Rotterdam, Netherlands.

出版信息

Lancet. 2004;364(9444):1519-21. doi: 10.1016/S0140-6736(04)17275-9.

Abstract

Although the safety profiles of coronary stents eluting sirolimus or paclitaxel do not seem to differ from those of bare metal stents in the short-to-medium term, concern has arisen about the potential for late stent thromboses related to delayed endothelialisation of the stent struts. We report four cases of angiographically-confirmed stent thrombosis that occurred late after elective implantation of polymer-based paxlitaxel-eluting (343 and 442 days) or sirolimus-eluting (335 and 375 days) stents, and resulted in myocardial infarction. All cases arose soon after antiplatelet therapy was interrupted. If confirmed in systematic long-term follow-up studies, our findings have potentially serious clinical implications.

摘要

尽管在短期至中期,洗脱西罗莫司或紫杉醇的冠状动脉支架的安全性似乎与裸金属支架并无差异,但人们已开始关注与支架小梁内皮化延迟相关的晚期支架血栓形成的可能性。我们报告了4例经血管造影证实的支架血栓形成病例,这些病例发生在择期植入基于聚合物的紫杉醇洗脱支架(343天和442天)或西罗莫司洗脱支架(335天和375天)后的晚期,并导致了心肌梗死。所有病例均在抗血小板治疗中断后不久出现。如果在系统性长期随访研究中得到证实,我们的发现可能具有严重的临床意义。

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