Rozenman Y, Mosseri M, Lotan C, Gotsman M S
Cardiology Dept., Hadassahì University Hospital, Jerusalem.
Harefuah. 1994 Jun 15;126(12):693-6, 764.
Balloon angioplasty is commonly used for coronary revascularization. Coronary stents were introduced to overcome its 2 main limitations: acute coronary occlusion and restenosis. We describe our experience with the use of 27 coronary stents in 26 patients. The indications for stenting were acute or threatened coronary occlusion in 16 patients, in 7 recurrent restenosis, and vein graft narrowing in the rest. Stent deployment was successful in all cases and there was no mortality. The hospital course was complicated by subacute thrombotic occlusion of the stent (2 patients) initially treated by balloon angioplasty, retroperitoneal bleeding (3), and surgical closure of femoral pseudoaneurysm (2); 22 were discharged without complications; 1 patient required coronary bypass. Coronary stenting has a high rate of success and is very effective in cases of abrupt coronary occlusion which would otherwise require emergency surgery. It is probably associated with a lower restenosis rate than standard balloon angioplasty. Accurately monitored anticoagulant therapy is essential to prevent complications.
球囊血管成形术常用于冠状动脉血运重建。冠状动脉支架的引入是为了克服其两个主要局限性：急性冠状动脉闭塞和再狭窄。我们描述了我们在26例患者中使用27个冠状动脉支架的经验。支架置入的适应证为16例急性或有急性冠状动脉闭塞风险的患者、7例复发性再狭窄患者，其余患者为静脉桥狭窄。所有病例的支架置入均成功，且无死亡病例。住院过程中出现了一些并发症，最初接受球囊血管成形术治疗的患者中有2例发生支架亚急性血栓闭塞，3例发生腹膜后出血，2例因股动脉假性动脉瘤需手术闭合；22例患者无并发症出院；1例患者需要冠状动脉搭桥术。冠状动脉支架置入成功率高，对于原本需要急诊手术的急性冠状动脉闭塞病例非常有效。它可能比标准球囊血管成形术的再狭窄率更低。准确监测抗凝治疗对于预防并发症至关重要。
