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目的 :评价紫杉醇药物洗脱支架 (TAXUS)应用的临床疗效。方法 :对 2 0 0 3年 4月～ 12月间 2 41例置入 3 0 8个TAXUS支架的临床疗效进行统计学分析。在 2 41例 2 82处病变中弥漫性病变 86处 ( 3 0 5 % ) ,分叉病变 5 6处 ( 19 9% ) ,慢性完全闭塞病变 41处 ( 14 5 % ) ,支架内再狭窄 3 3处 ( 11 7% ) ,开口部病变 2 4处 ( 8 5 % ) ,左冠状动脉主干病变 7处 ( 2 5 % )以及小血管病变或其它病变 3 5处 ( 12 4% )。结果 :支架置入成功率为 99 0 % ,术中无死亡 ,无急性血栓形成和急性血管闭塞发生 ,支架置入后分支血管发生闭塞12例 ( 2 1 4% ) ,住院期间死亡 1例 (死于出血性休克 ) ,发生急性心肌梗死 2例 (均由分支闭塞所致 ) ,住院期间心脏事件发生率为 1 2 % ,199例患者随访超过 6个月 ,1例院外猝死 ,2例发生急性心肌梗死 ,7例靶血管重建 ,心脏事件发生率为4 5 % ,靶病变重建率为 3 0 %。结论 :与TAXUSI～Ⅳ研究相比 ,本研究放宽病变的适应证后其再狭窄发生率仅轻度升高 ,提示对于复杂病变应用TAXUS仍是安全和有效的。
Objective: To evaluate the clinical efficacy of paclitaxel-eluting stent (TAXUS). Methods: The clinical efficacy of 241 TAXUS stents placed between April and December 2003 was analyzed. Of 241 cases (282%) with diffuse lesions (82%), 526 (19.9%) with bifurcation lesions, 41 (14.5%) with chronic total occlusion lesions and 3 3 (11.7%), 24 (85%) of the open lesions, 7 (25%) of the left coronary artery lesions, and 35 (12.4%) of the small vessel lesions or other lesions. Results: The success rate of stent implantation was 99.0%. There was no death during surgery, no acute thrombosis and acute vascular occlusion. There were 12 cases (21.4%) of branch vessel occlusion after stent implantation and 1 died during hospitalization Died of hemorrhagic shock), 2 cases of acute myocardial infarction (all caused by occlusion of the branch), 12% of cardiac events during hospitalization, 199 cases were followed up for more than 6 months, 1 case of sudden death from the hospital and 2 cases Acute myocardial infarction, target vessel revascularization in 7 cases, cardiac event rate was 45% and target lesion reconstruction rate was 30%. CONCLUSIONS: Compared with TAXUSI ~ Ⅳ study, the incidence of restenosis was only slightly increased in this study after indications were relaxed, suggesting that TAXUS is safe and effective for complicated lesions.