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[新型生物工程技术(内皮祖细胞捕获支架)用于治疗冠心病的临床结果]

[Clinical results of the use of new bioengineering technologies (endothelial precursor cell-capturing stents) in the treatment of coronary heart disease].

作者信息

Cherkavskaia O V, Rudenko B A, Kochetov A G, Savchenko A P, Gerasimov A M

出版信息

Vestn Rentgenol Radiol. 2012 Jan-Feb(1):9-16.

Abstract

OBJECTIVE

to study the long-term results of the use of precursor cell-capturing stents (bioengineering stents) and to analyze the factors influencing late prognosis.

SUBJECTS AND METHODS

The study included 447 coronary heart disease patients with primary atherosclerotic lesion in the coronary bed, damage to aortocoronary shunts, and restenosis of a previously implanted stent. The clinical and morphological risk factors for stent restenosis and late stent thrombosis were analyzed during a 2-year follow-up.

RESULTS

In the first year of the follow-up, there were no fatal outcomes, evolving myocardial infarction was observed in 2.6% of cases; recurrent angina pectoris was noted in 10.7%. No late stent thromboses were identified; the incidence of stent restenosis was 8.3%. The risk of restenosis was significantly increased after interventions on arteries less than 2.75 mm in diameter and extended lesions. During the 2-year follow-up, 2 (0.4%) patients died; 14 (1.4%) patients experienced transmural myocardial infarction; 35 (3.3%) patients had non-Q wave myocardial infarction. Forty-four (9.8%) and 15 (1.5%) patients underwent repeated endovascular revascularization and coronary artery bypass grafting, respectively. Late stent thromboses were absent; the incidence of restenosis was 11.7%.

CONCLUSION

Within the 2-year follow-up after implantation of bioengineering stents, recurrent angina was seen in 14.8% of the patients, which required repeated endovascular interventions in 9.8% of cases and coronary artery bypass surgery in 1.5% of cases. The incidence of bioengineering stent restenosis was 11.7%; no late thrombotic events were found. The risk factors for bioengineering stent restenosis were extended lesions and small-diameter vessel interventions.

摘要

目的

研究前体细胞捕获支架(生物工程支架)的长期使用效果,并分析影响远期预后的因素。

对象与方法

本研究纳入447例冠心病患者,这些患者冠状动脉床存在原发性动脉粥样硬化病变、主动脉冠状动脉分流受损以及先前植入支架再狭窄。在为期2年的随访期间,分析支架再狭窄和晚期支架血栓形成的临床及形态学危险因素。

结果

随访的第一年,无死亡病例,2.6%的病例发生进展性心肌梗死;10.7%的病例出现复发性心绞痛。未发现晚期支架血栓形成;支架再狭窄发生率为8.3%。对直径小于2.75 mm的动脉进行干预以及病变范围扩大后,再狭窄风险显著增加。在2年随访期间,2例(0.4%)患者死亡;14例(1.4%)患者发生透壁性心肌梗死;35例(3.3%)患者发生非Q波心肌梗死。分别有44例(9.8%)和15例(1.5%)患者接受了重复血管内血运重建和冠状动脉旁路移植术。无晚期支架血栓形成;再狭窄发生率为11.7%。

结论

在生物工程支架植入后的2年随访期内,14.8%的患者出现复发性心绞痛,其中9.8%的病例需要重复血管内干预,1.5%的病例需要冠状动脉旁路手术。生物工程支架再狭窄发生率为11.7%;未发现晚期血栓事件。生物工程支架再狭窄的危险因素为病变范围扩大和对小直径血管的干预。

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