Erbel R, Schatz R, Dietz U, Nixdorff U, Haude M, Aichinger S, Pop T, Meyer J
II. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität Mainz.
Z Kardiol. 1989 Feb;78(2):71-7.
To avoid acute complications and restenosis after percutaneous transluminal coronary angioplasty coronary stents were developed. For the first time three flexible Palmaz-Schatz stents were implanted after application and fixation by balloon inflation in two patients with severe lesions of the left anterior descending coronary artery. The vessels showed larger diameters with smoother surface and smaller gradients compared to balloon angioplasty as related to a blockade of the elastic properties of the vessel and suggested fixation of intima or media dissection. The implantation of the coronary stents was without complications. The control after 24 h showed an open vessel with unchanged diameter. The patients with the proximal lesion of the left anterior descending coronary artery six months later showed no restenosis and no luminal narrowing. The recanalized left anterior descending coronary artery, which was dilated, received two stents and was reoccluded after six months. Meanwhile, up to four stents were implanted successfully in an additional four patients with open vessels as the 24-h-control. Based on this and previous work the implantation of coronary stents seems to open a new dimension for percutaneous transluminal coronary angioplasty because vessel occlusions can be prevented. Whether or not the restenosis rate can be reduced has to be demonstrated in additional studies.
为避免经皮腔内冠状动脉成形术后出现急性并发症和再狭窄，冠状动脉支架应运而生。首次在两名左前降支冠状动脉严重病变患者中，通过球囊扩张应用并固定后植入了三个可弯曲的帕尔马兹 - 施塔茨支架。与球囊血管成形术相比，这些血管直径更大，表面更光滑，梯度更小，这与血管弹性特性的阻断有关，提示内膜或中膜夹层固定。冠状动脉支架植入无并发症。24小时后的检查显示血管通畅，直径未变。左前降支冠状动脉近端病变患者6个月后未出现再狭窄和管腔狭窄。扩张后的再通左前降支冠状动脉植入了两个支架，6个月后再次闭塞。与此同时，另外四名血管通畅的患者在24小时检查时成功植入了多达四个支架。基于此项及先前的工作，冠状动脉支架植入似乎为经皮腔内冠状动脉成形术开辟了一个新的领域，因为可以预防血管闭塞。再狭窄率是否能够降低还有待进一步研究证实。
