CORONARY STENT IMPLANTATION IN PATIENTS AFTER MULTIPLE PTCA RESTENOSIS

金属冠状动脉内支架已被提出作为一种治疗替代方案。 适用于标准球囊术后复发再狭窄的患者 血管成形术(PTCA)。假设再狭窄病理生理学的一个组成部分是 永久性可植入支架--血管节段的弹性后坐 应保留扩大的管腔尺寸并防止血流动力学 血管明显变窄。来检验这一假设 冠状动脉内支架置入术预防术后再狭窄 作为标准的PTCA，我们研究了一组患者的急性和长期反应 有至少2次再狭窄史的患者(n-21例)。 冠状动脉内支架被放置以覆盖先前再狭窄的部位 在标准的初级血管成形术后。虽然在某种程度上是新的 大多数随访血管造影术(术后4-6个月)均出现增殖 支架植入)，未观察到临床再狭窄和血管造影术 10例患者中仅1例在随访期内发生再狭窄。 虽然这只是一份初步报告，但我们鼓励使用这种支架 植入物在标准PTCA术后复发再狭窄中的应用 可能是改善长期血管通畅性的一种有益的治疗方式 并保持临床稳定。

Metallic intracoronary stents have been proposed as a treatment alternative for patients with episodes of recurrent restenosis after standard balloon angioplasty (PTCA). Assuming a component of restenosis pathophysiology is elastic recoil of the vessel segment, a permanent implantable scaffold should retain expanded lumen dimensions and prevent hemodynamically significant narrowing of the vessel. To test the hypothesis that intracoronary stent implantation prevents restenosis in patients after standard PTCA, we studied the acute and long-term responses in a group of patients (n-21) who have had at least 2 episodes of previous restenosis. Intracoronary stents were placed to cover sites of previous restenosis after standard primary angioplasty. Although some degree of neointamal proliferation was present in most follow-up angiograms (at 4-6 months after stent implantation), clinical restenosis was not observed and angiographic restenosis was noted only in 1 of 10 patients during the follow-up period. Although this represents a preliminary report, we are encouraged that stent implantation in the setting of recurrent restenosis after standard PTCA maybe a beneficial treatment modality to improve long-term vessel patency and maintain clinical stability.