Eltchaninoff H, Koning R, Tron C, Cribier A
Service de cardiologie, hôpital Charles Nicolle, Université de Rouen.
Arch Mal Coeur Vaiss. 1998 Dec;91(12):1459-63.
The aim of this prospective study was to assess the clinical and angiographic immediate and 6 month results of balloon angioplasty in intra-stent restenosis. Quantitative angiographic analysis (Philips DCI) was performed before and after implantation of the stent, before and after angioplasty for restenosis and at the 6 month control procedure. The study included 59 patients with 65 stents with an intra-stent restenosis. Restenosis was diffuse (10 mm) in 70% of cases, and focal in 30% of cases. The length of the stent was 16 +/- 7 mm (Palmaz-Schatz: 58%). The diameter of the balloon used for angioplasty was 2.9 +/- 0.4 mm and the maximal inflation pressure was 10 +/- 3 bars. The success rate was 100% with no complications. Control coronary angiography was performed in 92% of patients after an average of 5.9 months. The angiographic restenosis rate was 54% and revascularisation was required in 21 patients (36%). The restenosis rate was higher in cases of diffuse intra-stent restenosis (64%) than in focal restenosis (29%), p = 0.02. The authors conclude that balloon angioplasty for intra-stent restenosis is safe and carries a high success rate. Nevertheless, the angiographic restenosis rate at 6 months seems to be higher, especially in cases of diffuse restenosis.
这项前瞻性研究的目的是评估球囊血管成形术治疗支架内再狭窄的临床及血管造影即时和6个月的结果。在支架植入前后、再狭窄血管成形术前后以及6个月的对照检查时进行定量血管造影分析(飞利浦DCI)。该研究纳入了59例患者的65个发生支架内再狭窄的支架。70%的病例再狭窄为弥漫性(长度>10 mm),30%为局灶性。支架长度为16±7 mm(Palmaz-Schatz支架:58%)。用于血管成形术的球囊直径为2.9±0.4 mm,最大充盈压力为10±3 bar。成功率为100%,无并发症。92%的患者在平均5.9个月后进行了冠状动脉造影对照检查。血管造影再狭窄率为54%,21例患者(36%)需要再次血管重建。弥漫性支架内再狭窄病例的再狭窄率(64%)高于局灶性再狭窄(29%),p = 0.02。作者得出结论,球囊血管成形术治疗支架内再狭窄是安全的,成功率高。然而,6个月时的血管造影再狭窄率似乎较高,尤其是在弥漫性再狭窄病例中。