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目的:评估在冠心病患者,不同药物洗脱支架对于治疗冠状动脉完全闭塞病变的远期疗效。方法:122例完全闭塞病变[冠状动脉溶栓治疗临床试验(TIMI)0级血流,且闭塞时间>3个月]并成功置入Firebird支架(Firebird组,n=58)、Cypher支架(Cypher组,n=40)和Taxus支架(Taxus组,n=24)的患者入选本研究。术后12个月随访时进行定量冠状动脉造影分析,并观察住院期间,30天和12个月时不良心脏事件的发生和靶病变重复血管重建。结果:3组的基本临床特征和基础冠状动脉造影结果相似,支架置入成功率均为100。术后支架内最小管腔直径,3组间差异无统计学意义(P>0.05)。住院期间3组均无靶病变重复血管重建和死亡发生。在30天时,3组均无支架内血栓形成。12个月随访期间,严重不良心脏事件发生率和靶病变重复血管重建率,在Firebird组为5.2和3.4;Cy-pher组为10.0和5.0,其中死亡1例(2.5);Taxus组为12.5和12.5,均无显著性差异(P>0.05)。12个月定量冠状动脉造影分析显示:支架内最小管腔直径和管腔狭窄直经,在Firebird组和Cypher组无显著差异(P>0.05),但Taxus组与Firebird组和Cypher组比较均有显著差异(P<0.05)。同时支架内远期管腔丢失Firebird组和Cypher组也明显低于Taxus组(P<0.05)。Firebird组、Cypher组和Taxus组支架内再狭窄率分别为5.17,10.0和20.83,其中Taxus组2例发生支架内再闭塞(8.3),均无显著性差异。结论:在慢性完全闭塞病变患者,使用药物洗脱支架安全有效,且急性并发症发生率低。经雷帕霉素药物支架治疗患者再狭窄率及再闭塞率较低。
PURPOSE: To assess the long-term efficacy of different drug-eluting stents in the treatment of patients with coronary artery occlusion in patients with coronary heart disease. Methods: Totally 122 patients with complete occlusion (Grade 0 TIMI blood flow and occlusion time> 3 months) were successfully enrolled in the Firebird stent (Firebird group, n = 58), Cypher stent Group, n = 40) and Taxus stent (Taxus group, n = 24) were enrolled in this study. Quantitative coronary angiography was performed at 12-month follow-up. Adverse cardiac events and repeated vessel revascularization were observed at admission, 30 days and 12 months. Results: The basic clinical features of the three groups were similar to those of the basic coronary angiography. The successful rate of stent implantation was 100. There was no significant difference in the smallest lumen diameter between the three groups (P> 0.05). During the hospital stay, there was no target lesion in the 3 groups of repeated revascularization and death. At 30 days, there was no stent thrombosis in all three groups. At 12 months of follow-up, the incidence of serious adverse cardiac events and target vessel revascularization were 5.2 and 3.4 in the Firebird group, 10.0 and 5.0 in the Cy-pher group, respectively, with 1 death (2.5) and 12.5 in the Taxus group 12.5, no significant difference (P> 0.05). Quantitative coronary angiography at 12 months showed that there was no significant difference between the Firebird group and the Cypher group (P> 0.05), but there was a significant difference between the Taxus group and the Firebird group and the Cypher group Significant difference (P <0.05). At the same time, the long-term lumen loss in the stent was also lower in the Firebird and Cypher groups than in the Taxus group (P <0.05). Restenosis rate was 5.17, 10.0 and 20.83 in Firebird group, Cypher group and Taxus group, respectively. There was no significant difference in re-occlusion between two groups in Taxus group (8.3). Conclusion: In patients with chronic total occlusion, the use of drug-eluting stents is safe and effective, and the incidence of acute complications is low. Restenosis rate and reocclusion rate were lower in rapamycin-treated patients.