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目的 评价冠状动脉（冠脉）内支架在完全闭塞性冠脉血管成形术（ＰＴＣＡ）中应用的指征及其限制因素。方法 ８２ 例冠脉完全闭塞接受ＰＴＣＡ 患者，根据血管病变性质，决定是否给予置入支架治疗。分析支架应用的指征及其限制因素。术后随访６ 个月，发生心脏事件者行血管造影复查。结果 ８２例中，６６ 例相关冠脉再通成功，成功率为８０．５％ 。６６ 例中，Ａ 组２３ 处病变单纯球囊ＰＴＣＡ 后取得“支架样”效果，其中Ｂ１ 组３０ 处病变置入支架，支架置入率４５．５％ ，Ｂ２ 组１３ 处病变存在支架置入的限制因素而未置入支架，占１９．７％ 。临床随访期间，Ａ 组５ 例发生心脏事件，血管造影复查，２ 例再狭窄；Ｂ１ 组仅２例发生心脏事件，造影复查２ 例均再狭窄，需再次ＰＴＣＡ；Ｂ２ 组 ５ 例发生心脏事件，３ 例造影发现再狭窄。闭塞冠脉再通未成功１６ 例中３ 例出现心脏事件，其中１ 例死亡。结论 闭塞冠脉再通成功达支架样效果或置入支架有助于改善临床预后，但部分病变存在支架置入的限制因素，不适宜置入支架
Objective To evaluate the indications and limitations of coronary stent (PTCA) in complete occlusion coronary angioplasty (PTCA). Methods 82 cases of coronary artery occlusion patients with PTCA, according to the nature of vascular disease, decide whether to give placement of stent treatment. Analysis of stent application indications and their limitations. After 6 months of follow-up, cardiac events were reviewed by angiography. Results Of the 82 cases, 66 cases of related coronary recanalization success, the success rate was 80.5%. Among the 66 cases, 23 cases of group A were treated with PTCA, and 30 cases of group B1 were treated with stent placement, 45.5% of stent placement, and 13 cases of group B2 were treated with stent implantation Limitations were not placed in the stent, accounting for 19.7%. During the clinical follow-up period, 5 patients in group A underwent cardiac events and angiography, and 2 patients had restenosis. Only 2 patients in group B1 had cardiac events, 2 patients underwent angiography and restenosis, and required PTCA again. Five patients in group B2 had cardiac events, 3 cases of restenosis found angiography. Cardiac events occurred in 3 of 16 cases with failed recanalization of the coronary artery, of which 1 died. Conclusions The success of occlusion of coronary recanalization with stent-like effect or placement of stents can improve clinical prognosis, but some of the limitations of stent placement factors, inappropriate placement of stents