国产雷帕霉素长支架的临床应用与疗效评价

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1、第二军医大学硕士学位论文AbstractBackground：AccordingtoACC／AHAstandard,thelenthofdiffuselesion>20mmbelongstoCtypelesion．Treatmentofdiffuselongcoronaryarterystenosiswitllalongsegmentofbaremetalstentisassociatedwim1lighrestenosisrates(50％)andpoorerclinicaloutcome．Therefore，incontrasttoshorter

2、lesions，stentplacementfordiffuselydiseasedcoronarysegmentsisfrequentlyavoided．Theefficencyofthedrugelutingstent(DES)implantationhasbeenevaluatedinthecontextofafewlargerandomizedtrials．ThesignificanceofreductionrestenosishasbeenshowedinDES．ThereforeDESisusedmoreandmoregenerallyi

3、nclinicandtheindicationsofpercutaneouscoronaryinterventionshasbeenusedtolonglesion：bifurcationlesions，chronictotalocclusionlesions，evenleftmaincoronarylesion．Objective：ToevaluatetheefficiencyandsafetyofsinglelongSESstemandoverlappingSESstentsfortherapyofdiffusecoronarylesion．Me

4、thods：1．Studygroup：Thepatientpopulationconsistedofaconsecutiveseriesof341patients(354lesions)atChangHaihospitalCardiovascularMedicinewhohadbeentreatedwithsinglelongstcntwhichdefinedasastentedlengthover22mmandoverlappingstentwhichdefinedasastentedlengthover36turnwithoutgapsforde

5、novodiffusecoronarylesionsfromjune2006toFebruary2008．Ofthesepatients，256patients(2651esions)hadbeentreatedwithoverlappingSESand89withsinglelongSES．AngiographyWasattemptedifpatientsexperiencedanymajoradversecardiaceventinthefirst30daysaftertheprocedure．．allpatientscomplywiththef

6、ollowingstandards：(1)coronaryarterystenosis>75％andthelengthoflesions>28inln(2)non—stentrestenosis(3)consecutive1esions，afterstemimplantationstemwithoutgaps；．(4)patientslivinginShanghaitofacilitatefollow-up．2．Theprocedureofstentimplantation：StenttimplantationWasperformedaccordin

7、gtostandardtechniques，andtheoperatorsselectedstems．CompletelesioncoverageWasrecommended．aswellasangiographicoptimization、)I，ith20％residualstenosisbyvisualestimate．Duringtheprocedure，patientsreceivedabolusheparin100U／kg．Allpatientswerepretreated谢也aspirinandclopidogrel．Aspirin(30

8、0mg／day)andclopidogrel(300mg)Wasgivenbeforeprocedure．3