De Cesare N B, Bartorelli A L, Galli S, Loaldi A, Fabbiocchi F, Sganzerla P, Montorsi P, Guazzi M D
Institute of Cardiology, Monzino Foundation, IRCCS, Milan, Italy.
Am Heart J. 1996 Oct;132(4):716-20. doi: 10.1016/s0002-8703(96)90302-6.
We evaluated acute and long-term clinical and angiographic results of elective Palmaz-Schatz coronary stent implantation for left anterior descending coronary artery (LAD) ostial stenosis in 23 consecutive patients. Eight patients had stable angina, 14 had unstable angina, and 1 had recent myocardial infarction. Sixteen patients had single-vessel, 5 had double-vessel, and 2 had triple-vessel disease. Clinical success without major complications (death, acute myocardial infarction, emergency coronary artery bypass grafting) was obtained in all cases and technical success in 20 cases (86.9%). After stenting, minimal lumen diameter increased from 1.05 +/- 0.45 mm to 2.89 +/- 0.52 mm (p < 0.001), and percent diameter stenosis decreased from 65.49% +/- 13.36% to 2.94% +/- 19.93% (p < 0.001). One case of subacute thrombosis and no major bleeding occurred. Twenty patients were followed-up for 6 months, during which no acute cardiac event (death, acute myocardial infarction) was observed. Eighteen patients were eligible for follow-up coronary angiography; restenosis (> or = 50% diameter stenosis) was observed in 4 (22.2%). Minimal lumen diameter was 1.77 +/- 0.55 mm, percent diameter stenosis was 39.66% +/- 17.62%, late loss was 1.01 +/- 0.69 mm, net gain was 0.79 +/- 0.55 mm, and loss index (late loss/acute gain) was 0.53 +/- 0.37. This study suggests that elective Palmaz-Schatz stent implantation may be a safe and successful treatment of LAD ostial lesions and provides a large increase in lumen diameter.
我们评估了连续23例因左前降支冠状动脉（LAD）开口狭窄而择期植入Palmaz-Schatz冠状动脉支架的患者的急性和长期临床及血管造影结果。8例患者为稳定型心绞痛，14例为不稳定型心绞痛，1例近期发生过心肌梗死。16例患者为单支血管病变，5例为双支血管病变，2例为三支血管病变。所有病例均获得无重大并发症（死亡、急性心肌梗死、急诊冠状动脉搭桥术）的临床成功，20例（86.9%）获得技术成功。支架置入后，最小管腔直径从1.05±0.45mm增加到2.89±0.52mm（p<0.001），直径狭窄百分比从65.49%±13.36%降至2.94%±19.93%（p<0.001）。发生1例亚急性血栓形成，无重大出血事件。20例患者随访6个月，在此期间未观察到急性心脏事件（死亡、急性心肌梗死）。18例患者符合随访冠状动脉造影条件；4例（22.2%）观察到再狭窄（直径狭窄≥50%）。最小管腔直径为1.77±0.55mm，直径狭窄百分比为39.66%±17.62%，晚期管腔丢失为1.01±0.69mm，净增加为0.79±0.55mm，丢失指数（晚期管腔丢失/急性增加）为0.53±0.37。本研究表明，择期植入Palmaz-Schatz支架可能是治疗LAD开口病变的一种安全且成功的方法，可使管腔直径大幅增加。
