摘要
目的探讨冠脉内超声指导下使用药物涂层支架(DES)治疗支架内再狭窄的效果。方法43例45处再狭窄病变。冠脉造影(CAG)证实后,用冠脉内超声导管显像(IVUS)检查再狭窄病变处,并指导选用适当大小及长度DES支架再植入,然后再行IVUS检查,对扩张不满意者行后扩张,术后随访。结果IVUS示原支架植入时有扩张不充分(38%)及支架贴壁不良(24%),其他为支架覆盖不全、扩张过度、钙化扭曲变形等。再植入DES释放压力(13±5)atm,行后扩张33处(73%),后扩张压力(15±7)atm。29例行CAG随访示再次再狭窄1例(3.4%)。结论应用IVUS明确冠脉支架内再狭窄特点,选用合适DES,并在其指导下释放及后扩张对支架内再狭窄治疗,再次再狭窄率明显降低。
Objective To investigate the efficacy of intravascular ultrasound （IVUS）-guided drug-eluting stent（DES） for the treatment of in-stent restenosis. Methods Fourty-five stent restenosis lesions of 43 consecutive patients with stent restenosis lesions were initially checked by IVUS. The size and length of DES were chosen depending on the results of IVUS. The dilating pressure 13 ±5 atm of DES and post-dilation 15 ± 7 atm were decided by the results of IVUS either. Results The IVUS showed that the old stents were not usually completely dilated（38%） and not tightly contacted with the arterial wa11（24%）. The follow-up of angiography in 29 patients indicated that the re-restenosis in the patients treated by IVUS-guided DES was small （1 case, 3.4%）. Conclusion The results suggest that IVUS-guided DES is effective for the treatment of in-stent restenosis
出处
《江苏医药》
CAS
CSCD
北大核心
2007年第7期693-695,共3页
Jiangsu Medical Journal
