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使用依维莫司洗脱生物可吸收血管支架治疗的ST段抬高型心肌梗死(STEMI)患者的短期预后

Short-term outcome of patients with ST-segment elevation myocardial infarction (STEMI) treated with an everolimus-eluting bioresorbable vascular scaffold.

作者信息

Wiebe Jens, Möllmann Helge, Most Astrid, Dörr Oliver, Weipert Kay, Rixe Johannes, Liebetrau Christoph, Elsässer Albrecht, Achenbach Stephan, Hamm Christian, Nef Holger

机构信息

Department of Cardiology, Medizinische Klinik I, University of Giessen, Klinikstrasse 33, 35392, Giessen, Germany.

出版信息

Clin Res Cardiol. 2014 Feb;103(2):141-8. doi: 10.1007/s00392-013-0630-x. Epub 2013 Oct 18.

DOI:10.1007/s00392-013-0630-x
PMID:24136291
Abstract

OBJECTIVES

To evaluate safety and efficacy of the everolimus-eluting bioresorbable scaffold (BVS) in patients with ST-segment elevation myocardial infarction (STEMI).

BACKGROUND

According to the current guidelines, drug-eluting stents are the treatment of choice in patients with STEMI. BVS represents a new technology capable to restore the native vessel vasomotion and potentially avoiding long-term limitations such as stent thrombosis.

METHODS

From October 2012 to May 2013, patients with evidence of STEMI eligible for BVS implantation were included in this study. Exclusion criteria were not defined.

RESULTS

A total of 25 patients, respectively 31 lesions, were treated. Procedural success was achieved in 97%. Two major adverse cardiac events occurred during hospitalization and follow-up: one patient with cardiogenic shock at the index procedure subsequently died. One patient suffered from instable angina with need for interventional revascularization of a previously untreated vessel. One target vessel failure as a consequence of an intra-procedural dissection was seen. However, no target lesion failure was noted. During 132.7 ± 68.7 days of follow-up none of the patients died.

CONCLUSION

Our findings suggest that implantation of BVS in STEMI patients is feasible in this small cohort of highly selected patients. Further evaluation in randomized-controlled trials is needed.

摘要

目的

评估依维莫司洗脱生物可吸收支架(BVS)在ST段抬高型心肌梗死(STEMI)患者中的安全性和有效性。

背景

根据现行指南,药物洗脱支架是STEMI患者的治疗选择。BVS是一项能够恢复血管自然舒缩功能并可能避免诸如支架内血栓形成等长期局限性的新技术。

方法

2012年10月至2013年5月,将有证据表明适合植入BVS的STEMI患者纳入本研究。未定义排除标准。

结果

共治疗25例患者,共31处病变。手术成功率为97%。住院期间和随访期间发生了两起主要不良心脏事件:1例患者在首次手术时发生心源性休克,随后死亡。1例患者发生不稳定型心绞痛,需要对先前未治疗的血管进行介入性血运重建。观察到1例因术中夹层导致的靶血管失败。然而,未观察到靶病变失败。在132.7±68.7天的随访期间,无患者死亡。

结论

我们的研究结果表明,在这一小群经过高度选择的患者中,在STEMI患者中植入BVS是可行的。需要在随机对照试验中进行进一步评估。

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