Higashitani Michiaki, Mori Fumiaki, Yamada Norihiro, Arashi Hiroyuki, Kojika Asako, Hoshi Hiromi, Minami Yuichiro, Yamaguchi Junichi, Yamauchi Takao, Takagi Atsushi, Ogawa Hiroshi, Hagiwara Nobuhisa
Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 160-0022, Japan.
Heart Vessels. 2011 Nov;26(6):582-9. doi: 10.1007/s00380-010-0110-4. Epub 2011 Jan 26.
Hemodialysis patients were recognized as a high-risk group for restenosis after percutaneous coronary intervention in the era of the bare-metal stent. Recently, sirolimus-eluting stents (SES) have reduced restenosis and target lesion revascularization (TLR); however, it has been reported that their efficacy in hemodialysis patients is limited. The purpose of this study was to investigate whether paclitaxel-eluting stents (PES) improved angiographic outcomes of hemodialysis patients compared with SES. This study is a retrospective cohort study. We analyzed 54 hemodialysis patients with 87 lesions implanted with PES from February 2007 to September 2008, and 49 hemodialysis patients with 68 lesions implanted with SES from August 2004 to January 2007. Angiographic follow-up after 8-10 months was obtained for 59 lesions (67.8%) in the PES group and 43 lesions (63.2%) in the SES group. At baseline, the PES patients had more peripheral artery disease compared with the SES group (66.7 vs. 34.7%; p = 0.0012). There were no significant differences in the angiographic characteristics or procedural index. The binary restenosis rate was lower in lesions implanted with PES than in those with SES (13.6 vs. 39.5%; p = 0.034). Accordingly, the TLR rate was lower in lesions implanted with PES than with SES (9.3 vs. 26.5%; p = 0.041). Our results suggest that PES is more effective than SES in reducing restenosis and TLR in hemodialysis patients.
在裸金属支架时代，血液透析患者被认为是经皮冠状动脉介入治疗后再狭窄的高危人群。近年来，西罗莫司洗脱支架（SES）已降低了再狭窄率和靶病变血管重建率（TLR）；然而，有报道称其在血液透析患者中的疗效有限。本研究的目的是调查与SES相比，紫杉醇洗脱支架（PES）是否能改善血液透析患者的血管造影结果。本研究为回顾性队列研究。我们分析了2007年2月至2008年9月期间植入PES的54例血液透析患者的87处病变，以及2004年8月至2007年1月期间植入SES的49例血液透析患者的68处病变。PES组59处病变（67.8%）和SES组43处病变（63.2%）在8 - 10个月后进行了血管造影随访。基线时，PES组患者的外周动脉疾病比SES组更多（66.7%对34.7%；p = 0.0012）。血管造影特征或手术指标无显著差异。植入PES的病变的二元再狭窄率低于植入SES的病变（13.6%对39.5%；p = 0.034）。相应地，植入PES的病变的TLR率低于植入SES的病变（9.3%对26.5%；p = 0.041）。我们的结果表明，在降低血液透析患者的再狭窄率和TLR方面，PES比SES更有效。
