Tresukosol D, Schalij M J, Savalle L H, Jukema J W, Buis B, Reiber J H, Bruschke A V
Department of Cardiology, University Hospital Leiden, The Netherlands.
Cathet Cardiovasc Diagn. 1996 Jun;38(2):135-43. doi: 10.1002/(SICI)1097-0304(199606)38:2<135::AID-CCD4>3.0.CO;2-A.
The Micro stent (MS) is a radiopaque stainless steel balloon expandable intracoronary stent. The stent is mounted on a rapid-exchange delivery system. From August 1994-March 1995, 127 MS were implanted in 85 patients (pts, 1.5 stents/pt, 85 in native vessels and 42 in bypass vein grafts, 61 males and 24 female, age 33-77 yr, mean age 61 +/- 10 yr). Pts studied were scheduled for either elective PTCA (n = 62, 73%) or PTCA for acute myocardial infarction (n = 23, 27%). Elective stent implantation was performed in 45 pts (53%). An MS was implanted because of a suboptimal balloon angioplasty result in 26 pts (31%). The stent was implanted because of threatened or acute vessel closure after balloon angioplasty in 14 pts (16%). During the procedure, 500 mg aspirin and 2 x 7,500 units of heparin were administered intravenously, followed by systemic heparinization for 48 hr. Pts were discharged with 100 mg aspirin daily (n = 50, 59%), or anticoagulant drugs and 100 mg aspirin daily (n = 19, 22%), or anticoagulant drugs only (n = 16, 19%). Angiographic results were analyzed with computer-assisted quantitative coronary arteriography. Angiographic success (defined as a residual stenosis of < 30%) was achieved in 124 of 127 attempts (98%). The mean minimal luminal diameter of the target lesions increased from 0.88 +/- 0.79 mm before stent implantation to 3.08 +/- 0.56 mm (P < 0.001). The percentage of diameter stenosis was reduced from 77.9 +/- 20.9% before to 13.3 +/- 10.5% (P < 0.001) after stent implantation. The average initial gain was 2.53 +/- 1.37 mm. The procedural success rate (defined as a residual stenosis of < 30% without occurrence of major clinical events within 3 wk after procedure) was 84%. Major clinical events included: death 1 pt (1%); cerebrovascular accident, 1 pt (1%); subacute stent closure, 5 pts (6%); coronary artery bypass grafting, 3 pts (4%); false femoral aneurysm, 2 pts (2%). The initial results of Micro stent implantation are promising. No anticoagulant therapy was given to most of the patients (59%). Few vascular and bleeding complications were observed. However, at this stage, no data about the restenosis rate after implantation of a Micro stent are available.
微型支架(MS)是一种不透射线的不锈钢球囊扩张型冠状动脉支架。该支架安装在快速交换输送系统上。1994年8月至1995年3月,85例患者植入了127枚MS(平均每位患者植入1.5枚支架,85枚植入天然血管,42枚植入搭桥静脉移植物;男性61例,女性24例,年龄33 - 77岁,平均年龄61±10岁)。研究的患者计划进行择期经皮冠状动脉腔内血管成形术(PTCA,n = 62,73%)或急性心肌梗死的PTCA(n = 23,27%)。45例患者(53%)进行了择期支架植入。26例患者(31%)因球囊血管成形术效果欠佳而植入MS。14例患者(16%)因球囊血管成形术后出现血管濒临闭塞或急性闭塞而植入支架。手术过程中,静脉注射500毫克阿司匹林和2×7500单位肝素,随后进行48小时全身肝素化。患者出院时,50例(59%)每日服用100毫克阿司匹林,19例(22%)服用抗凝药物并每日服用100毫克阿司匹林,16例(19%)仅服用抗凝药物。采用计算机辅助定量冠状动脉造影分析血管造影结果。127次尝试中有124次(98%)获得血管造影成功(定义为残余狭窄<30%)。靶病变的平均最小管腔直径从支架植入前的0.88±0.79毫米增加到3.08±0.56毫米(P<0.001)。直径狭窄百分比从术前的77.9±20.9%降至术后的13.3±10.5%(P<0.001)。平均初始增加量为2.53±1.37毫米。手术成功率(定义为残余狭窄<30%且术后3周内未发生重大临床事件)为84%。重大临床事件包括:死亡1例(1%);脑血管意外,1例(1%);亚急性支架闭塞,5例(6%);冠状动脉搭桥术,3例(4%);股动脉假性动脉瘤,2例(2%)。微型支架植入的初步结果令人鼓舞。大多数患者(59%)未接受抗凝治疗。观察到的血管和出血并发症较少。然而,现阶段尚无微型支架植入后再狭窄率的数据。