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[使用西罗莫司涂层超长支架(4060毫米)治疗冠状动脉广泛弥漫性病变患者的首次经验]

[The First Experience of Using Very Long Stents Covered With Sirolimus (4060 mm) in the Treatment of Patients With Extensive and Diffuse Lesions of the Coronary Arteries].

作者信息

Matchin Yu G, Atanesyan R V, Kononets E N, Danilov N M, Bubnov D S, Ageev F T

机构信息

Institute of Cardiology of Russian Cardiology Scientific and Production Complex, Moscow, Russia.

出版信息

Kardiologiia. 2017 Apr;57(4):19-26.

Abstract

OBJECTIVES

To assess the clinical outcome of one year follow-up in patients with diffuse long lesions treated with extra-long sirolimus-eluting stents.

METHODS AND RESULTS

85 patients underwent implantation of very long BioMime stents during the period from March 2014 to February 2016.

RESULTS

The angiographic success rate was 100%, clinical success was observed in 98.8% cases (one patient developed periprocedural MI). The additional back-up support for stent delivery was used in 11 (12.9%) patients (the "buddy wire" technique in 6 pts and Guidzilla catheter in 2 pts.). Cumulative MACE rate at 12 months was 9.4% with 1.1% myocardial infarction and 5.9% TLR. One patient died 6 month after stent implantation from massive pulmonary thromboembolism. None of the patients had subacute or late stent thrombosis. Follow-up angiography was performed in 48 (68.5%) patients, 5 (10.4%) patients demonstrated restenoses.

CONCLUSION

The use of extra-long sirolimus-eluting stents is associated with good procedural and one-year clinical outcomes in complex patients with long and diffuse lesions.

摘要

目的

评估使用超长西罗莫司洗脱支架治疗弥漫性长病变患者一年随访的临床结果。

方法与结果

2014年3月至2016年2月期间,85例患者接受了超长生物可吸收支架植入术。

结果

血管造影成功率为100%,98.8%的病例观察到临床成功(1例患者发生围手术期心肌梗死)。11例(12.9%)患者使用了额外的支架输送辅助支撑(6例采用“伙伴导丝”技术,2例采用Guidzilla导管)。12个月时累积主要不良心血管事件(MACE)发生率为9.4%,心肌梗死发生率为1.1%,靶病变血运重建(TLR)发生率为5.9%。1例患者在支架植入6个月后死于大面积肺血栓栓塞。无患者发生亚急性或晚期支架血栓形成。48例(68.5%)患者进行了随访血管造影,5例(10.4%)患者出现再狭窄。

结论

对于患有长而弥漫性病变的复杂患者,使用超长西罗莫司洗脱支架与良好的手术效果和一年临床结果相关。

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