Marzocchi A, Piovaccari G, Marrozzini C, Ortolani P, Palmerini T, Branzi A, Magnani B
Istituto di Malattie dell'Apparato Cardiovascolare di Bologna, Italy.
Cathet Cardiovasc Diagn. 1997 Aug;41(4):371-6. doi: 10.1002/(sici)1097-0304(199708)41:4<371::aid-ccd3>3.0.co;2-2.
Coronary stenting with the half disarticulated Palmaz-Schatz stent is particularly suitable for ostial stenoses, diaphragm stenoses, stenoses distal to tortuous segments or coronary bends and localized dissections after balloon angioplasty. Nevertheless very few data regarding the half stent exist and follow-up data are nonexistent. From January of 1994 to December of 1995 a total of 207 half stents were implanted in 175 patients. Most patients had stable or unstable angina and in the majority of cases the stent was implanted due to localized dissection or to suboptimal result. The procedural success rate was 98%. After stent implantation, 82 patients were treated with acetylsalicylic acid (ASA) and oral anticoagulant (group A), whereas 93 were treated with ASA and ticlopidine (group B). Seven patients had subacute thrombosis (5, group A; 2, group B), and six patients had major bleeding (5, group A; 1, group B). Overall, patients in group A had more cardiovascular complications than patients in group B (10, group A; 3, group B; p = 0.047). After 6-mo follow-up, 1 patient had died and 27 patients had symptoms of angina (16%). Thirteen patients underwent a second PTCA (7%) and four patients (2%) were referred for coronary artery bypass. In conclusion, coronary stenting with half Palmaz-Schatz stent appears to be a safe and effective procedure. In selected cases, the half Palmaz-Schatz stent is easier to handle than the complete stent, it is associated with a low rate of clinical restenosis, and it lowers procedural costs.
使用半节段Palmaz-Schatz支架进行冠状动脉支架置入术特别适用于开口处狭窄、隔膜狭窄、迂曲段或冠状动脉弯曲远端的狭窄以及球囊血管成形术后的局限性夹层。然而，关于半节段支架的数据非常少，且不存在随访数据。1994年1月至1995年12月，共175例患者植入了207个半节段支架。大多数患者患有稳定型或不稳定型心绞痛，在大多数情况下，植入支架是由于局限性夹层或效果欠佳。手术成功率为98%。支架植入后，82例患者接受阿司匹林（ASA）和口服抗凝剂治疗（A组），而93例患者接受ASA和噻氯匹定治疗（B组）。7例患者发生亚急性血栓形成（A组5例；B组2例），6例患者发生大出血（A组5例；B组1例）。总体而言，A组患者的心血管并发症比B组患者更多（A组10例；B组3例；p = 0.047）。6个月随访后，1例患者死亡，27例患者有心绞痛症状（16%）。13例患者接受了第二次经皮冠状动脉腔内血管成形术（PTCA）（7%），4例患者（2%）接受了冠状动脉旁路移植术。总之，使用半节段Palmaz-Schatz支架进行冠状动脉支架置入术似乎是一种安全有效的手术。在某些情况下，半节段Palmaz-Schatz支架比完整支架更易于操作，临床再狭窄率低，且降低了手术成本。
