【摘要】 目的探讨极晚期支架内血栓(LVST)形成原因及处理。方法回顾性分析2005年6月~2010年6月植入雷帕霉素药物洗脱支架(DES)治疗冠状动脉狭窄1548例(共植入2642枚支架)中发生LVST病例的发病和处理的具体情况。结果 1548例中发生2例LVST,LVST发生率为0.13%,1例LVST发生在支架术后41个月(三年半),另1例LVST发生在支架术后26个月(二年两个月)。两例均为停止用双联抗血小板治疗后发生支架内血栓。经过充分的抗栓治疗同时行球囊扩张治疗,血栓影消失,无残余狭窄,未再植入支架。随访75个月,病人无不适症状。结论 LVST形成原因复杂,与停用双抗有关。充分的抗栓同时行球囊扩张治疗是有效的方法。更多还原

【Abstract】 Objective To explore the causes and the treatment of very late stent thrombosis.Methods Among 1548 cases with coronary stenosis lesions undergoing 2642 rapamycin drug-eluting stents(DES) implantation two patients with LVST were retrospectively analyzed from June 2005 to June 2010.Results Among 1548 cases with coronary stents implantation two cases suffered from LVST. The incidence rate of LVST was 0.13%. 1 case with in-stent thrombosis occurred in 41 months after stenting(three and a half years), and the other case with LVST occurred in 26 months after stenting.Two cases with LVST all occurred in stop using dual antiplatelet therapy.For those patients full antithrombotic treatment and balloon expansion were performed at the same time.The thrombus shadow in-stent disappeared.There was no residual stenosis in target coronary vessels.Stent implantation was not performed again. The patients were Follow-up of 75 months and without symptoms.Conclusion The causes of LVST is complex and related to stop using double antiplatelet.The balloon expansion and at the same time fully antithrombotic therapy are effective method.更多还原