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使用紫杉醇洗脱支架或西罗莫司洗脱支架进行挤压式支架置入术治疗冠状动脉分叉病变。

Crush stenting with paclitaxel-eluting or sirolimus-eluting stents for the treatment of coronary bifurcation lesions.

作者信息

Chen Shaoliang, Zhang Junjie, Ye Fei, Zhu Zhongsheng, Lin Song, Tian Nailiang, Liu Zhizhong, Fang Weiyi, Chen Yundai, Sun Xuewen, Kwan Tak W

机构信息

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

出版信息

Angiology. 2008 Aug-Sep;59(4):475-83. doi: 10.1177/0003319707312519. Epub 2008 Apr 2.

Abstract

Two hundred forty-six patients with 252 bifurcation lesions were enrolled into a prospective, nonrandomized study to use paclitaxel-eluting or sirolimus-eluting stent for crush stenting in the treatment of coronary bifurcation lesions. Compared with the sirolimus-eluting stent group, the paclitaxel-eluting stent group had significantly higher mean late lumen and binary angiographic restenosis rates. Sirolimus-eluting stent versus paclitaxel-eluting stent recipients had significantly lower in-segment restenosis in the entire main vessel (15.7% vs 3.1%, P = .004), and simultaneous side branch and main vessel restenoses were solely detected in the paclitaxel-eluting stent group (11.9% vs 0%, P = .03). Target-lesion vessel revascularization and cumulative major adverse cardiac events rates were significantly higher in the paclitaxel-eluting versus the sirolimus-eluting stent group (17.99% vs 8.41%, P = .01; 19.4 vs 9.3%, P = .01; 23.6 vs 11.2%, P = .03). In this study with crush stenting, use of sirolimus-eluting stent, compared with paclitaxel-eluting stent, yielded significantly lower late lumen loss, restenosis, and revascularization rates, with comparable safety by 8-month follow-up.

摘要

246例患有252处分叉病变的患者被纳入一项前瞻性、非随机研究,该研究使用紫杉醇洗脱支架或西罗莫司洗脱支架进行挤压式支架置入术来治疗冠状动脉分叉病变。与西罗莫司洗脱支架组相比,紫杉醇洗脱支架组的平均晚期管腔和二元血管造影再狭窄率显著更高。接受西罗莫司洗脱支架与紫杉醇洗脱支架的患者在整个主血管中的节段内再狭窄显著更低(15.7%对3.1%,P = 0.004),并且仅在紫杉醇洗脱支架组中检测到同时发生的边支和主血管再狭窄(11.9%对0%,P = 0.03)。紫杉醇洗脱支架组的靶病变血管重建和累积主要不良心脏事件发生率显著高于西罗莫司洗脱支架组(17.99%对8.41%,P = 0.01;19.4对9.3%,P = 0.01;23.6对11.2%,P = 0.03)。在这项采用挤压式支架置入术的研究中,与紫杉醇洗脱支架相比, 使用西罗莫司洗脱支架产生的晚期管腔丢失、再狭窄和血管重建率显著更低,在8个月的随访中安全性相当。

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