Morice M C, Zemour G, Benveniste E, Biron Y, Bourdonnec C, Faivre R, Fajadet J, Gaspard P, Glatt B, Joly P
Centre Cardiologique du Nord, Saint-Denis, France.
Cathet Cardiovasc Diagn. 1995 May;35(1):1-7. doi: 10.1002/ccd.1810350102.
In order to simplify post-coronary stenting treatment and to obtain a lower rate of complications, especially in bailout situations, seven French institutions treated 246 stented patients with 0.25 g/day of ticlopidine, 0.1 g/day of IV aspirin, and 2 days of heparin followed by low-molecular-weight heparin for 1 month. Fifty percent of patients had a planned stenting procedure, and 50% had an unplanned procedure, including 29 (11.8%) in bailout situations. Subacute occlusion occurred in three (1.2%) patients (one death, two non-Q-wave infarctions). During the 1 month follow-up period, another death was reported (non-stent-related), two elective coronary artery bypass grafts were performed, and three additional patients presented with non-Q-wave myocardial infarctions. Nine (3.7%) patients had a groin complication that required blood transfusion or surgical repair. These results suggest that while waiting for the technological advancements of stents, postprocedural treatment that includes a low dosage of ticlopidine, aspirin, and low-molecular-weight heparin is a very effective alternative to conventional poststenting therapy.
为了简化冠状动脉支架置入术后的治疗并降低并发症发生率，尤其是在紧急救援情况下，法国的七家机构对246例接受支架置入术的患者采用了如下治疗方案：每日口服0.25克噻氯匹定、每日静脉注射0.1克阿司匹林，并给予2天肝素治疗，随后给予低分子量肝素治疗1个月。50%的患者接受了计划性支架置入手术，50%的患者接受了非计划性手术，其中包括29例（11.8%）紧急救援情况。3例（1.2%）患者发生亚急性闭塞（1例死亡，2例非Q波梗死）。在1个月的随访期内，报告了另外1例死亡（与支架无关），进行了2例择期冠状动脉搭桥手术，另有3例患者出现非Q波心肌梗死。9例（3.7%）患者出现腹股沟并发症，需要输血或手术修复。这些结果表明，在等待支架技术进步的同时，包括低剂量噻氯匹定、阿司匹林和低分子量肝素在内的术后治疗是传统支架置入术后治疗的一种非常有效的替代方案。
