摘要
目的 为探讨冠状动脉内支架治疗急性心肌梗塞的可行性和安全性。方法 对４６ 例经球囊扩张后效果不理想的急性心肌梗塞（ＡＭＩ）患者行冠脉内支架置入。其中男３８ 例，女８ 例，平均年龄为５６．２ 岁。全部采用球囊扩张法置入支架。结果 ４６ 例患者术前梗塞相关血管均为ＴＩＭＩ３ 级血流，经置入冠脉内支架后梗塞血管均恢复ＴＩＭＩⅢ级血流，血管开通率１００％ 。８ 例球囊扩张后见冠脉内有残余血栓，置入支架后消失，造影未发现血栓进入远端血管；１ 例患者因Ⅲ°ＡＶＢ 给以临时起搏治疗，术后 ６小时因临时起搏电极刺破右室所致心包填塞死亡。其余 ４５ 例患者在４～３８ 个月的随访中均未发生死亡，无梗塞后心绞痛及再次心肌梗塞，６ 例患者于术后４ 周行冠脉造影复查，原支架置入处血流通畅，无管腔再狭窄。
Objective To evaluate the initial experience of intracoronary stenting in patients with acute myocardial infarction (AMI) in our hospital Methods Balloon expansion stents were deployed in 46 patients with AMI after emergency percutaneous transluminal coronary angioplasty (PTCA) Results Coronary angiography (CAG) showed that all patients ( n =46) had a single vessel occlusion (TIMI 0 grade blood flow in distal segment of infarct related vessels) before emergency PTCA and were successfully restored to TIMI 3 grade blood flow after intracoronary stenting Minor residual intracoronary thrombosis was presented in 8 of 46 patients after PTCA, and it was totally disappeared after stenting; One patient with inferior infarction developed Ⅲ degree atria ventricular blockade (AVB) and temporary pacemaker was introduced This patient died of cardiac tamponade 6 h after stenting due to right ventricular perforation by electrode No cardiac death, recurrent angina and reinfarction occurred during the 4～16 months follow up period in the other 45 patients; No angiographically restenosis was found in all the 6 patents who had a secondary coronary angiography 4 weeks after stenting These results suggest that intracoronary stenting is a highly effective stategy in prevention or treatment of acute reocclusion after emergency PTCA in AMI Conclusion Minor residual intracoronary thrombosis after balloon dilation was not a contraindication for stent implantation
出处
《中国介入心脏病学杂志》
1999年第3期102-104,共3页
Chinese Journal of Interventional Cardiology
关键词
急性
心肌梗塞
血管成形
支架
Acute myocardial infarction Angioplasty Stent
