Li Jian-jun, Xu Bo, Yang Yue-jin, Chen Ji-lin, Qiao Shu-bing, Ma Wei-hua, Qin Xue-wen, Yao Min, Liu Hai-bo, Wu Yong-jian, Yuan Jin-qing, Chen Jue, You Shi-jie, Dai Jun, Xia Ran, Gao Run-lin
Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
Chin Med J (Engl). 2008 Jan 5;121(1):6-11.
Calcified coronary lesions carry the risk of suboptimal stent expansion, subsequently leading to restenosis. The effectiveness of sirolimus-eluting stents (SES) for the treatment of calcified lesion has not been fully investigated. In the present study, therefore, we evaluated the effectiveness of SES implantation for the treatment of calcified coronary lesions.
A total of 333 consecutive patients with 453 lesions were enrolled in this study. They were divided into two groups according to whether the lesion treated with SES was calcified or not; no calcification group (n = 264) and calcification group (n = 189). Lesions treated with SES were subjected to quantitative coronary angiography (QCA) immediately and 8 months following stenting.
Baseline clinical, demographic or angiographic characteristics were well balanced in both groups. Angiographic follow-up at 8 months, the in-stent restenosis and in-segment restenosis rates were not significantly different between the two groups; in-stent restenosis: 3.8% vs 4.2%; P = 0.081; in-segment restenosis: 8.7% vs 10.6%, P = 0.503. The target lesion revascularization (TLR) was also not significantly different between the two groups; 4.9% vs 6.9%, P = 0.378. In addition, the in-stent late loss was similar in both groups; (0.16 +/- 0.40) mm vs (0.17 +/- 0.33) mm, P > 0.05. Meantime, overall thrombosis rates were also similar in both groups; 1.6% vs 1.6%, P > 0.05.
Although calcified coronary lesion was hard to stent, successful percutaneous coronary intervention with SES stenting for calcified lesions was conferred by the similar favorable results that were seen when comparing non-calcified and calcified coronary lesions.
钙化冠状动脉病变存在支架扩张不理想的风险,进而导致再狭窄。西罗莫司洗脱支架(SES)治疗钙化病变的有效性尚未得到充分研究。因此,在本研究中,我们评估了SES植入治疗钙化冠状动脉病变的有效性。
本研究共纳入333例连续患者的453处病变。根据接受SES治疗的病变是否钙化,将患者分为两组;无钙化组(n = 264)和钙化组(n = 189)。接受SES治疗的病变在支架置入后即刻和8个月时进行定量冠状动脉造影(QCA)。
两组的基线临床、人口统计学或血管造影特征均衡良好。在8个月时的血管造影随访中,两组的支架内再狭窄率和节段内再狭窄率无显著差异;支架内再狭窄率:3.8% 对4.2%;P = 0.081;节段内再狭窄率:8.7% 对10.6%,P = 0.503。两组的靶病变血运重建(TLR)也无显著差异;4.9% 对6.9%,P = 0.378。此外,两组的支架内晚期管腔丢失相似;(0.16 ± 0.40)mm对(0.17 ± 0.33)mm,P > 0.05。同时,两组的总体血栓形成率也相似;1.6% 对1.6%,P > 0.05。
尽管钙化冠状动脉病变难以置入支架,但与非钙化冠状动脉病变相比,SES支架置入术成功进行经皮冠状动脉介入治疗钙化病变的效果相似。