药物洗脱支架再狭窄或血栓形成处理后的长期预后
Long-term outcomes after management of restenosis or thrombosis of drug-eluting stents.
作者信息
Mishkel Gregory J, Moore Anna L, Markwell Steve, Shelton M Coleman, Shelton Marc E
机构信息
Prairie Heart Institute at St. John's Hospital, Springfield, Illinois 62794, USA.
出版信息
J Am Coll Cardiol. 2007 Jan 16;49(2):181-4. doi: 10.1016/j.jacc.2006.08.049. Epub 2006 Dec 29.
OBJECTIVES
The purpose of this study was to examine the outcomes of patients who developed coronary in-stent restenosis (ISR) or stent thrombosis (STH) inside drug-eluting stents (DES).
BACKGROUND
Drug-eluting stents have markedly reduced the incidence of restenosis. However, when restenosis occurs within a DES, its optimal management remains unclear.
METHODS
We retrospectively analyzed clinical and angiographic data from 92 patients who underwent revascularization for ISR (n = 84) or STH (n = 8) within a DES at our institution. Regular follow-ups were available up to 2 years. We recorded the occurrence of major adverse cardiac events (MACE), defined as deaths from all causes, myocardial infarction (MI), or target lesion revascularization (TLR), among patients treated by the "DES sandwich" technique or by other treatment methods.
RESULTS
In-hospital MACE included 1 periprocedural MI and 2 deaths. Over a mean follow-up of 15 +/- 6 months, the overall rates of death, MI, and TLR were 8.7%, 2.2%, and 30.6%, respectively. By actuarial analysis, the 12-month TLR and MACE rates were 28.2% and 42.9%, respectively.
CONCLUSIONS
Current treatments of ISR or STH in DES are associated with a high long-term rate of MACE.
目的
本研究旨在探讨药物洗脱支架（DES）内发生冠状动脉支架内再狭窄（ISR）或支架血栓形成（STH）患者的预后情况。
背景
药物洗脱支架已显著降低再狭窄发生率。然而，当DES内发生再狭窄时，其最佳治疗方案仍不明确。
方法
我们回顾性分析了在我院接受DES内ISR（n = 84）或STH（n = 8）血管重建术的92例患者的临床和血管造影数据。可进行长达2年的定期随访。我们记录了采用“DES夹层”技术或其他治疗方法治疗的患者中主要不良心脏事件（MACE）的发生情况，MACE定义为各种原因导致的死亡、心肌梗死（MI）或靶病变血管重建（TLR）。
结果
住院期间的MACE包括1例围手术期MI和2例死亡。平均随访15±6个月，死亡、MI和TLR的总体发生率分别为8.7%、2.2%和30.6%。通过精算分析，12个月时的TLR和MACE发生率分别为28.2%和
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