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血管成形术后使用自膨胀平行丝金属支架进行冠状动脉支架置入术。

Coronary artery stenting after angioplasty with self-expanding parallel wire metallic stents.

作者信息

Bonan R, Bhat K, Lefèvre T, Lemarbre L, Paiement P, Wolff R, Leung T K

机构信息

Department of Medicine, Montreal Heart Institute, Quebec, Canada.

出版信息

Am Heart J. 1991 May;121(5):1522-30. doi: 10.1016/0002-8703(91)90161-a.

DOI:10.1016/0002-8703(91)90161-a
PMID:2017984
Abstract

Parallel wire stents were implanted over exchange guide wires at percutaneous transluminal coronary angioplasty sites in 27 canine coronary arteries that were predilated with slightly oversized balloons. Stents were stainless steel, self-expandable, 3.5 to 4.5 mm in diameter, 9 to 12 mm in length, and were made of 10 wires that were longitudinally laser-welded in a zig-zag design. The compressible stent was delivered by the withdrawal of a Teflon outer catheter (4.2 to 4.9F) and the push of a polyethylene inner catheter. Aspirin, 80 mg per day, was given from the day before the study began, and heparin (150 U/kg) was administered during implantation. Quantitative angiography and pathologic examinations were performed at day 0 and at weeks 2, 4, 12, 26 and 52. The coronary angiographic diameter at the stent site immediately after stenting marginally increased from diameter before stenting: 3.22 +/- 0.40 mm versus 3.14 +/- 0.37 mm (p = 0.03), and during a mean of 14 weeks of follow-up, remained unaltered from immediate post-stenting: 3.29 +/- 0.43 mm versus 3.22 +/- 0.40 mm (p = NS) with no stent displacement. Comparisons of patency and thrombosis between heparin-coated and uncoated stents, between left anterior descending and circumflex arteries, and among the three different diameters of stents showed uniformly good results. At microscopy, the wires were oriented perfectly and embedded in the arterial wall, and by 2 weeks they were covered by mucopolysaccharide ground substance, smooth muscle cells, and an almost complete monolayer of neoendothelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在27条犬冠状动脉经皮腔内冠状动脉成形术部位,于用略大于血管直径的球囊预扩张后,通过交换导丝植入平行钢丝支架。支架为不锈钢材质,可自膨胀,直径3.5至4.5毫米,长度9至12毫米,由10根钢丝纵向激光焊接呈之字形结构制成。可压缩支架通过回撤聚四氟乙烯外导管(4.2至4.9F)并推送聚乙烯内导管来输送。从研究开始前一天起给予阿司匹林,每日80毫克,植入期间给予肝素(150单位/千克)。在第0天以及第2、4、12、26和52周进行定量血管造影和病理检查。支架植入后即刻,支架部位的冠状动脉造影直径较植入前略有增加:3.22±0.40毫米对3.14±0.37毫米(p = 0.03),在平均14周的随访期间,与支架植入后即刻相比保持不变:3.29±0.43毫米对3.22±0.40毫米(p =无显著性差异),且无支架移位。肝素涂层支架与未涂层支架之间、左前降支与回旋支动脉之间以及三种不同直径支架之间的通畅率和血栓形成比较均显示出一致的良好结果。显微镜检查显示,钢丝排列完美并嵌入动脉壁,到第2周时,它们被粘多糖基质、平滑肌细胞和几乎完整的单层新生内皮细胞覆盖。(摘要截短于250字)

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引用本文的文献

1
Neointima formation following arterial placement of self-expanding stents of different radial force: experimental results.不同径向力的自膨胀支架动脉置入后的新生内膜形成:实验结果
Cardiovasc Intervent Radiol. 1994 Jan-Feb;17(1):27-32. doi: 10.1007/BF00197911.
2
Intracoronary stents.冠状动脉内支架
Br Heart J. 1992 Jun;67(6):425-7. doi: 10.1136/hrt.67.6.425.