Suzuki Shuji, Kamihata Hiroshi, Hata Tetsuya, Hayashi Fujio, Miura Akira, Yoshinaga Masahiro, Karakawa Masahiro, Kitaura Yasushi
Third Division, Department of Internal Medicine, Osaka Medical College, Takatsuki, and Department of Cardiology, Kyoto Kujo Hospital, Japan.
Circ J. 2007 Jan;71(1):15-9. doi: 10.1253/circj.71.15.
The sirolimus-eluting stent (SES) is currently the sole drug-coated stent approved for use in Japan, but there are few reports on its safety and outcomes in Japan.
From May 2004 to February 2005, a total of 297 patients with 402 lesions were treated with SES at 6 hospitals in the Kansai district. Follow-up angiography was performed in 82% of the patients and 80% of the lesions at 182+/-35 days after stenting. Coronary stenosis was evaluated using quantitative coronary angiography. Clinical and angiographic data were analyzed. Minimum lesion diameter was 0.75+/-0.52 mm and the reference diameter was 2.81+/-0.47 mm before stenting. The SES successfully dilated 99.5% of the lesions with few major adverse cardiac events. Restenosis occurred in 4.0% and the target lesion revascularization rate was 3.7%. Restenosis correlated with chronic hemodialysis, calcification, occlusion, ostial lesions, lesions kinked>45 degrees, right coronary artery (RCA) lesions and lesions at the ostium of the RCA.
SES demonstrated a high rate of successful implantation with few complications, and mid-term outcomes were excellent. Patients with lesions at the ostium of the RCA or under chronic hemodialysis developed restenosis.
西罗莫司洗脱支架(SES)是目前在日本唯一被批准使用的药物涂层支架,但在日本关于其安全性和疗效的报道较少。
2004年5月至2005年2月,关西地区6家医院共对297例患者的402处病变进行了SES治疗。在支架置入后182±35天,82%的患者和80%的病变接受了随访血管造影。采用定量冠状动脉造影评估冠状动脉狭窄情况。对临床和血管造影数据进行分析。支架置入前最小病变直径为0.75±0.52mm,参考直径为2.81±0.47mm。SES成功扩张了99.5%的病变,主要不良心脏事件较少。再狭窄发生率为4.0%,靶病变血管重建率为3.7%。再狭窄与慢性血液透析、钙化、闭塞、开口病变、病变扭曲>45度、右冠状动脉(RCA)病变以及RCA开口处病变相关。
SES显示出高成功率的植入率且并发症较少,中期疗效良好。RCA开口处病变或接受慢性血液透析的患者发生了再狭窄。