Ozbek C, Heisel A, Gross B, Bay W, Schieffer H
University Clinic of the Saarland, Division of Internal Medicine III (Department of Cardiology and Angiology), Homburg, Germany.
Cathet Cardiovasc Diagn. 1997 May;41(1):71-8. doi: 10.1002/(sici)1097-0304(199705)41:1<71::aid-ccd17>3.0.co;2-t.
Coronary stenting in bail-out situations is effective but associated with increased stent thrombosis and bleeding rates. Silicone-carbide coating reduces fibrinogen activation on alloplastic surfaces and thus may also reduce stent thromboses. A total of 44 patients received 58 silicone-carbide-coated stents for threatened (80%) or abrupt (20%) closure. In addition to heparin, patients were treated with aspirin and ticlopidine (75%) or aspirin (25%) only. Two patients (4.5%) died in the hospital. The combined in-hospital complication rate including death, emergency revascularization, stent-related myocardial infarction, and stent thrombosis was 9% (4 of 44 patients). Major bleeding occurred in 4 patients (9%). Six-month follow-up angiography was obtained in all eligible patients (42 of 44), revealing a restenosis rate of 21% (9 of 42). Thus, coronary implantation of silicone-carbide-coated stents is feasible in bail-out situations without oral anticoagulation and with a low complication rate. Further studies are required to optimize the anticoagulation regimen with this type of coating.
在补救性情况下进行冠状动脉支架置入术是有效的，但与支架血栓形成和出血率增加相关。碳化硅涂层可减少异物表面的纤维蛋白原激活，因此也可能减少支架血栓形成。共有44例患者接受了58枚碳化硅涂层支架，用于治疗濒临闭塞（80%）或突然闭塞（20%）的病变。除肝素外，患者仅接受阿司匹林和噻氯匹定治疗（75%）或仅接受阿司匹林治疗（25%）。两名患者（4.5%）在医院死亡。包括死亡、急诊血管重建、支架相关心肌梗死和支架血栓形成在内的院内综合并发症发生率为9%（44例患者中的4例）。4例患者（9%）发生大出血。对所有符合条件的患者（44例中的42例）进行了6个月的随访血管造影，显示再狭窄率为21%（42例中的9例）。因此，在补救性情况下，无需口服抗凝剂且并发症发生率较低时，植入碳化硅涂层支架进行冠状动脉介入治疗是可行的。需要进一步研究以优化这种涂层类型的抗凝方案。
