REPEAT DILATION OF INTRAVASCULAR STENTS IN CONGENITAL HEART-DEFECTS
REPEAT DILATION OF INTRAVASCULAR STENTS IN CONGENITAL HEART-DEFECTS
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DOI：
10.1161/01.cir.92.4.893
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发表时间：
1995-08-15
期刊：
影响因子：
37.8
通讯作者：
MULLINS, CE
中科院分区：
文献类型：
--
作者：
ING, FF;GRIFKA, RG;MULLINS, CE
背景血管内（Palmaz）支架已成功植入先天性和获得性分支肺动脉狭窄患者。早期结果非常好;但是，没有关于先天性心脏病患者再狭窄和重复扩张的信息。本研究的目的是审查再狭窄的发生率，并证明在这组patients.Methods和结果的94例患者163植入支架的支架重复扩张的安全性和有效性，在这个单中心的研究，43例患者73植入支架进行再导管插入术。73枚再研究支架中仅2枚（3%）发生了显著再狭窄。在20例患者中，30枚支架被再次扩张。支架植入时，该亚组的平均年龄为14.2岁，平均管腔直径从4.9 mm增加到10.7 mm（P=.0001），支架上的收缩压差（平均值）从52 mm Hg降低到11 mm Hg（P=.0001）。在再置管时（平均13个月），所有支架均通畅。平均直径减小1.2 mm（P=.0001），但梯度（平均值3 mm Hg）增加不显著（P=.11）。重复扩张后，直径从9.5 mm增加到12.2 mm（P=.0001），梯度从14 mm Hg降低到8 mm Hg（P=.0003）。2枚支架再狭窄均成功扩张。2例患者在18个月和26个月时成功进行了3枚支架的第二次再扩张。结论所有支架均保持通畅。显著再狭窄的发生率较低（3%），这些再狭窄可以再扩张和/或再支架化。在分支肺动脉狭窄中植入的Palmaz支架的重复扩张可在支架植入后长达3年内安全有效（成功率94%）。
Background Intravascular (Palmaz) stents have been successfully implanted in patients with congenital and acquired branch pulmonary stenosis. Early results are excellent; however, there is no information on restenosis and repeat dilation in patients with congenital heart disease. The purpose of this study is to review the incidence of restenosis and demonstrate the safety and efficacy of repeat dilation of stents in this group of patients.Methods and Results Of 94 patients with 163 implanted stents in this single-center study, 43 patients with 73 implanted stents underwent recatheterization. Only 2 of 73 restudied stents (3%) developed significant restenosis. In 20 patients, 30 stents were redilated. At stent implantation, the mean age of this subgroup was 14.2 years, the mean intraluminal diameter increased from 4.9 to 10.7 mm (P=.0001), and the systolic gradient (mean) across the stent decreased from 52 to 11 mm Hg (P=.0001). At recatheterization (mean, 13 months), all stents were patent. The mean diameter decreased by 1.2 mm (P=.0001), but the increase in the gradient (mean, 3 mm Hg) was not significant (P=.11). After repeat dilation, the diameter increased from 9.5 to 12.2 mm (P=.0001), and the gradient decreased from 14 to 8 mm Hg (P=.0003). The 2 stents with restenosis were redilated successfully. Two patients underwent a successful second redilation of 3 stents at 18 and 26 months. There were no complications.Conclusions All stents remained patent. The occurrence of significant restenosis is low (3%), and these restenoses can be redilated and/or restented. Repeat dilation of the Palmaz stent implanted in branch pulmonary artery stenosis can be per formed with safety and efficacy (94% success rate) up to 3 years after stent implantation.