【摘要】 目的　评价PC支架治疗小直径冠状动脉血管病变的手术成功率、术后主要临床不良事件发生情况及远期再狭窄率。方法　观察我院 1998年 4月至 2 0 0 1年 5月 4 5例小血管 (血管直径 <2 8mm)患者冠心病患者植入PC支架的手术成功率、主要临床不良事件发生情况及远期再狭窄率。随访 1个月至 3年 ,其中 2 8例行冠状动脉造影术复查。结果　手术成功率 10 0 % ,支架全部顺利置入。血管狭窄率由 (82± 10 ) %改善至术后的 (0± 5 ) % (直径法 )。术后 30d随访 ,1例支架内 5 0 %狭窄。 1例术后第 2 2天因急性左心衰死亡。术后 6个月随访 38例。 1例支架完全闭塞 ,1例原支架内及近远端多发性狭窄 ,考虑合并其他血管病变 ,给予搭桥术。 35例随访时间 3年。完全无症状 2 6例。 2例随访过程中支架内狭窄 ,1例术后第 2年因心血管事件死亡。术后第 3年 ,有 2 8例在行冠脉造影复查 ,PC支架植入的 30处 ,6处发生支架内再狭窄 (狭窄 >5 0 % ) ,2例出现支架近端狭窄。冠脉造影再狭窄率为 2 6 6 7% ,总再狭窄率为 2 5 5 %。结论　小血管PC支架术手术成功率高 ,术后即刻效果好 ,术后远期生存率较高 ,再狭窄率接近大血管 >3 0mm普通裸支架更多还原

【Abstract】 Objectives To observe the results of the rate of success of procedure, main adverse cardiac events and restenosis after stent placement in small coronary vessels. Methods 45 patients with PC stent implantation in 50 small vessels (diameter<2.8 mm) from April, 1998 to May, 2001. Immediate success of procedure, main adverse cardiac events,and restenosis after stent placement were observed. Follow up 1 month-3 years. Re-catheter angiography were done in 28/35 patients. Results The rate of success of procedure was 100%, 50 PC stents were implanted successfully in 50 lesions without any event. The rate of narrowing of lesion declined from (82±10)% before procedure to (0±5)% after procedure (diameter). With 1-month follow-up, 1 case occurred a 50% in-stent-restenosis, 1 case died of acute heart failure 22 days after procedure. 38 cases were followed up 6 months. 1 case had a total occlusion in the PC stent, 1 case was referred to CABG for in-stent-restenosis and with other lesions. 35 were followed up 3 years. 26 cases were syndrome-free. 2 cases happened in-stent-restenosis during follow-up. 1 case died of cardiac event. 28 cases underwent re-angiography 3 years after procedures. 6 in-stent-restenosis occurred in 30 PC stents. 2 cases had stenosis proximal to stents. The rate of restenosis was 26.67% angiographilly, and the total rate of restenosis was 25.5%. Conclusions There was a high rate of success of procedure and perfect immediate outcome in PC stent placement in small vessels without main adverse cardiac events increased. Long-term survival was acceptable in follow-up. Therate of long-term Restenosis was similar to that in bigger >3.0 mm vessels.更多还原