目的:评价雷帕霉素洗脱支架(CYPHER支架)治疗冠状动脉(冠脉)复杂病变的安全性及疗效。方法:143例复杂病变且有临床缺血症状的患者接受了CYPHER支架治疗,196处靶病变共置入231个CYPHER支架。观察手术成功率、并发症、随访期间心脏不良事件发生率、再狭窄率及晚期管腔丢失情况等。结果:所有支架均成功置入,无残余狭窄或残余狭窄<10%,未见任何并发症。临床随访11±4·4(5~22)个月,临床随访率94%,有7例(5·2%)症状再发,后经冠状动脉造影证实其中4例为支架内再狭窄所致,需再次血运重建,其余患者均未发生任何心脏不良事件,无一例死亡。术后6~18(9±2·3)个月共109例患者复查冠脉造影,造影随访率76·2%,支架近端边缘节段平均晚期管腔丢失(0·22±0·02)mm,支架内平均晚期管腔丢失(0·25±0·04)mm,支架远端边缘节段(0·10±0·02)mm;病变再狭窄率2·6%,病例复发率5·2%,再次血运重建率3·4%。结论:CY-PHER支架治疗冠脉复杂病变安全、有效,能明显降低6个月后的支架内再狭窄率及再次血运重建率。 Objective: To evaluate the safety and efficacy of rapamycin-eluting stent (CYPHER) in the treatment of complicated coronary artery (coronary artery) disease. METHODS: One hundred and forty-three patients with complex lesions who had clinical symptoms of ischemia were treated with CYPHER and 231 CYPHER stents were placed in 196 lesions. Surgical success rate, complications, incidence of cardiac adverse events during follow-up, restenosis rate and late luminal loss were observed. Results: All stents were successfully placed without any residual stenosis or residual stenosis <10% without any complications. The clinical follow-up was 11 ± 4 · 4 (5 ~ 22) months. The clinical follow-up rate was 94%. Seven patients (5.2%) had recurrent symptoms. Coronary angiography confirmed that 4 of them were caused by in-stent restenosis , Need revascularization again, the rest of the patients did not have any cardiac adverse events, and no one died. Coronary angiography was performed in 109 patients 6 to 18 (9 ± 2.3) months after operation, with a follow-up rate of 76.2%. The average late lumen loss at the proximal edge of the stent was 0.22 ± 0.02 ) mm, mean late stent loss within the stent (0 · 25 ± 0 · 04) mm, distal segment of the stent (0 · 10 ± 0 · 02) mm; lesion restenosis rate 2.6%, case relapse rate 5.2%, and the rate of revascularization was 3.4% again. CONCLUSIONS: CY-PHER stent is safe and effective in the treatment of complex coronary arteries and can significantly reduce the rate of in-stent restenosis and revascularization after 6 months.