冠状动脉内置入Bestent支架42例(摘要)
作者：张立新 姚立云 王乐丰 张学坤 郭金成 李乃达
单位：北京市，通州区潞河医院 心内科(101149)
关键词：
中国循环杂志99zk50 目的：评估冠状动脉内置入Bestent支架的临床疗效。
方法：1997年10月至1998年10月共有42例冠心病患者接受了冠状动脉Bestent支架置入术。其中男35例，女7例，年龄44～78(55.4±13.7)岁。不稳定性心绞痛12例，稳定性心绞痛1例，非Q波心肌梗塞3例，急性心肌梗塞26例(前壁13例，下壁12例，后壁1例)。静脉溶栓12例，冠状动脉内溶栓1例。冠状动脉再通7例。合并高血压15例，糖尿病5例，高血脂9例，吸烟24例，冠状动脉旁路移植术1例。冠状动脉造影示单支病变24例，双支病变12例，三支病变6例。部位：前降支开口3处，近段21处，中段2处，回旋支近段2处，中段3处，右冠状动脉近段3处，中段8处，钝缘支近段1处。病变类型：A型16处，B型23处，C型4处。支架置入原因为球囊扩张后弹性回缩(DeNovo病变)、残余狭窄(suboptimal病变)和内膜撕裂、夹层(Bail-out病变)。术后常规服用噻氯匹定和阿司匹林抗凝。所有患者术后定期门诊随访。统计数据用
±s表示，自身对照t检验。
, 百拇医药
结果：在置入的43个Bestent支架中，DeNovo支架置入21个，Suboptimal支架置入17个，Bail-out支架置入4个，置入失败1个。其中前降支26个，回旋支5个，右冠状动脉11个，钝缘支1个，置入成功率为97.5%。狭窄程度由术前的(86.4±14.6)%降至术后的(5.8±9.2)%，(P<0.001)，前后对比差异显著。术中发生心室颤动2例，术后死亡1例，穿刺部位拔管后发生皮下血肿4例。所有患者术后随诊半年，有6例心绞痛复发，复发率为14.3%,其中2例经冠状动脉造影证实为术后再狭窄，再狭窄率为4.8%。
结论：冠状动脉内Bestent支架置入是一种安全有效的介入技术，其成功率高且并发症低，有利于改善冠心病患者的预后。
Clinical Report of Intracoronary Bestent Stent (42 Cases) (Abstract)
Department of Cardiology, Luhe Hospital Tongzhou Distrit, Beijing (101149)
, 百拇医药
Zhang Lixin, Yao Liyun, Wang Lefeng, et al.
Objective: To evaluate the clinical results of intracoronary implantation of Bestent stent.
Methods: Fourty-three coronary artery vessels of 42 cases with coronary heart disease (CHD) were treated by 43 Bestent stents in our hospital from October, 1997 to October, 1998. 35 males and 7 females, aged from 44～78 (55.4±13.7) years. 12 patients with unstable angina, 1 with stabel angina 3 with non-Q-wave myocardial infarction and 26 with acute myocardial infarction (AMI) (13 in anterior, 12 in inferior 1 in posterior). 13 cases with AMI were treated by thrombolytic therapy (13 by intravenous and 1 by intracoronary artery) and 7 cases of them had reperfusion. 15 cases combined with hypertention, 5 cases with diabetes and 9 with hyperlipidemia. 1 cases had history of smoking and 24 with coronary artery bypass grafting (CABG). 24 patients had one-vessel lesion, 12 had two- vessel lesions and 6 had three-vessel lesion. 26 lesions in left anterior descending branch (LAD), 5 lesions in left circumflex branch (LCX), 11 lesions in rigth coronary artery (RCA) and 1 lesion in obtuse marginal (OM). According to the AHA/ACC classification, 16 lesions were A type, 23 lesions B type and 4 lesions C type. Bestent stent was implanted into artery because of de novo, suboptimal and bail- out lesions after percutanous transluminal coronary angioplasty (PTCA). Ticlid and Aspirin were administered orally as a routine of postoperation and all patients were followed- up in out-patient for 6 monthes.
, 百拇医药
Results: In all of 43 Bestent stents, there were 21 de novo stenting, 17 suboptimal stenting, 4 bail-out stenting and 1 stent implantation failed. 26 stents were implanted into LAD, 5 stents into LCX, 11 stents into RCA and 1 stent into OM. The success rate of implantation was 97.5%. Diameter stenoses was reduced significantly [(86.4±14.6)% vs. (5.8±9.2)%, p<0.001] after operation. 2 cases had ventricular fibrillation during operation, 1 case died and 4 cases had subcutaneous hematoma after implantation. 6 cases (14.3%) had recurrence of angina and 2 cases (4.8%) were found restenoses after stent implantation.
Conclusion: This report showed that intracoronary Bstent stenting is a safe and effective interventional procedure with high success rate and very few complications. It may improve the prognosis of patients with CHD., 百拇医药
单位：北京市，通州区潞河医院 心内科(101149)
关键词：
中国循环杂志99zk50 目的：评估冠状动脉内置入Bestent支架的临床疗效。
方法：1997年10月至1998年10月共有42例冠心病患者接受了冠状动脉Bestent支架置入术。其中男35例，女7例，年龄44～78(55.4±13.7)岁。不稳定性心绞痛12例，稳定性心绞痛1例，非Q波心肌梗塞3例，急性心肌梗塞26例(前壁13例，下壁12例，后壁1例)。静脉溶栓12例，冠状动脉内溶栓1例。冠状动脉再通7例。合并高血压15例，糖尿病5例，高血脂9例，吸烟24例，冠状动脉旁路移植术1例。冠状动脉造影示单支病变24例，双支病变12例，三支病变6例。部位：前降支开口3处，近段21处，中段2处，回旋支近段2处，中段3处，右冠状动脉近段3处，中段8处，钝缘支近段1处。病变类型：A型16处，B型23处，C型4处。支架置入原因为球囊扩张后弹性回缩(DeNovo病变)、残余狭窄(suboptimal病变)和内膜撕裂、夹层(Bail-out病变)。术后常规服用噻氯匹定和阿司匹林抗凝。所有患者术后定期门诊随访。统计数据用
±s表示，自身对照t检验。, 百拇医药
结果：在置入的43个Bestent支架中，DeNovo支架置入21个，Suboptimal支架置入17个，Bail-out支架置入4个，置入失败1个。其中前降支26个，回旋支5个，右冠状动脉11个，钝缘支1个，置入成功率为97.5%。狭窄程度由术前的(86.4±14.6)%降至术后的(5.8±9.2)%，(P<0.001)，前后对比差异显著。术中发生心室颤动2例，术后死亡1例，穿刺部位拔管后发生皮下血肿4例。所有患者术后随诊半年，有6例心绞痛复发，复发率为14.3%,其中2例经冠状动脉造影证实为术后再狭窄，再狭窄率为4.8%。
结论：冠状动脉内Bestent支架置入是一种安全有效的介入技术，其成功率高且并发症低，有利于改善冠心病患者的预后。
Clinical Report of Intracoronary Bestent Stent (42 Cases) (Abstract)
Department of Cardiology, Luhe Hospital Tongzhou Distrit, Beijing (101149)
, 百拇医药
Zhang Lixin, Yao Liyun, Wang Lefeng, et al.
Objective: To evaluate the clinical results of intracoronary implantation of Bestent stent.
Methods: Fourty-three coronary artery vessels of 42 cases with coronary heart disease (CHD) were treated by 43 Bestent stents in our hospital from October, 1997 to October, 1998. 35 males and 7 females, aged from 44～78 (55.4±13.7) years. 12 patients with unstable angina, 1 with stabel angina 3 with non-Q-wave myocardial infarction and 26 with acute myocardial infarction (AMI) (13 in anterior, 12 in inferior 1 in posterior). 13 cases with AMI were treated by thrombolytic therapy (13 by intravenous and 1 by intracoronary artery) and 7 cases of them had reperfusion. 15 cases combined with hypertention, 5 cases with diabetes and 9 with hyperlipidemia. 1 cases had history of smoking and 24 with coronary artery bypass grafting (CABG). 24 patients had one-vessel lesion, 12 had two- vessel lesions and 6 had three-vessel lesion. 26 lesions in left anterior descending branch (LAD), 5 lesions in left circumflex branch (LCX), 11 lesions in rigth coronary artery (RCA) and 1 lesion in obtuse marginal (OM). According to the AHA/ACC classification, 16 lesions were A type, 23 lesions B type and 4 lesions C type. Bestent stent was implanted into artery because of de novo, suboptimal and bail- out lesions after percutanous transluminal coronary angioplasty (PTCA). Ticlid and Aspirin were administered orally as a routine of postoperation and all patients were followed- up in out-patient for 6 monthes.
, 百拇医药
Results: In all of 43 Bestent stents, there were 21 de novo stenting, 17 suboptimal stenting, 4 bail-out stenting and 1 stent implantation failed. 26 stents were implanted into LAD, 5 stents into LCX, 11 stents into RCA and 1 stent into OM. The success rate of implantation was 97.5%. Diameter stenoses was reduced significantly [(86.4±14.6)% vs. (5.8±9.2)%, p<0.001] after operation. 2 cases had ventricular fibrillation during operation, 1 case died and 4 cases had subcutaneous hematoma after implantation. 6 cases (14.3%) had recurrence of angina and 2 cases (4.8%) were found restenoses after stent implantation.
Conclusion: This report showed that intracoronary Bstent stenting is a safe and effective interventional procedure with high success rate and very few complications. It may improve the prognosis of patients with CHD., 百拇医药