Foley J B, Penn I M, Brown R I, Murray-Parsons N, White J, Galligan L, MacDonald C
Victoria Hospital, University of Western Ontario, London, Canada.
Am Heart J. 1993 Mar;125(3):686-94. doi: 10.1016/0002-8703(93)90159-7.
We report the immediate safety, efficacy, and 6-month angiographic follow-up after elective implantation of the Palmaz-Schatz stent (Johnson & Johnson Interventional Systems, Warren, N.J.) in the first 100 consecutive patients at a single center. Patients with suitable cardiac anatomy and no contraindications to anticoagulation were prospectively entered into the study. One hundred two stents were successfully implanted in 99 patients. The mean diameter stenosis was 70% +/- 11% before implantation and was reduced to 20% +/- 11% after stent implantation. There were no deaths, Q-wave myocardial infarcts, urgent bypass operations, or strokes during the procedure or follow-up period. Stent thrombosis occurred in two patients; in both vessel patency was successfully accomplished by balloon angioplasty. There were three gastrointestinal hemorrhages, two of which required transfusion. Angiographic follow-up was performed in 98% of patients at 6.3 +/- 2.6 months after the procedure. Restenosis (> or = 50% stenosis within or immediately adjacent to the stent) occurred in 32%. Stent restenosis was associated with male sex (36% vs 7% for female subjects; p = 0.03) and stent implantation in a restenosis lesion (47% vs 25% for de novo lesions; p = 0.03); it was inversely associated with current cigarette smoking (0% vs 36% for nonsmokers; p = 0.02). In conclusion, the Palmaz-Schatz stent can be electively implanted with high success and low complication rates. The restenosis rate appears to be similar to that of balloon angioplasty.
我们报告了在单一中心对连续100例患者择期植入帕尔马兹 - 沙茨支架（强生介入系统公司，新泽西州沃伦）后的即时安全性、有效性及6个月的血管造影随访结果。具有合适心脏解剖结构且无抗凝禁忌证的患者被前瞻性纳入研究。99例患者成功植入了102枚支架。植入前平均直径狭窄率为70%±11%，支架植入后降至20%±11%。在手术过程或随访期间未发生死亡、Q波心肌梗死、紧急搭桥手术或中风。两名患者发生支架血栓形成；通过球囊血管成形术均成功实现血管再通。发生了3例胃肠道出血，其中2例需要输血。98%的患者在术后6.3±2.6个月进行了血管造影随访。再狭窄（支架内或紧邻支架处狭窄≥50%）发生率为32%。支架再狭窄与男性性别（男性36%，女性7%；p = 0.03）以及在再狭窄病变处植入支架（再狭窄病变处为47%，初发病变处为25%；p = 0.03）有关；与当前吸烟呈负相关（非吸烟者为0%，吸烟者为36%；p = 0.02）。总之，帕尔马兹 - 沙茨支架可择期植入，成功率高且并发症发生率低。再狭窄率似乎与球囊血管成形术相似。
