冠状动脉异位和动脉瘤急性冠状动脉综合征患者经皮肾支架植入术的安全性和有效性结果。

Postgraduate medicine Pub Date : 2024-01-01 Epub Date: 2024-02-05 DOI:10.1080/00325481.2024.2313447
Sencer Çamci, Hasan Ari, Ayşe Sünbül, Selma Ari, Mehmet Melek, Tahsin Bozat
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引用次数: 0

摘要

背景:在治疗扩张的冠状动脉中出现的狭窄病变时,由于血管直径过大,很难找到尺寸合适的冠状动脉支架。这就造成了更大的问题,尤其是对于需要紧急干预的患者,如急性冠状动脉综合征患者:我们旨在评估在此类患者异位/动脉瘤冠状动脉中植入肾动脉支架的有效性和安全性:本中心共纳入了 18 名在异位/动脉瘤性冠状动脉中植入肾支架并需要经皮冠状动脉介入治疗(PCI)的患者(肾支架组)和 45 名植入大尺寸裸金属冠状动脉支架(BMCS)的患者(BMCS 组)。主要终点是MACE(心肌梗死和心血管疾病死亡率),次要终点是再狭窄和全因死亡率:研究患者的平均随访时间为 25.3 ± 14.6 个月(1 至 48 个月),肾支架组的冠状动脉造影对照时间为 24.6 ± 14.8 个月,BMCS 组为 22.8 ± 15.7 个月(P = 0.06)。肾支架组有 2 例(11.1%)患者发生 MACE,BMCS 组有 4 例(8.9%)患者发生 MACE(HR:1.39 (0.24-7.82),P = 0.70)。肾支架组中有 4 例(22.2%)患者出现了次要综合结果,BMCS 组中有 6 例(13.7%)患者出现了次要综合结果(HR:1.93 (0.53-6.91),P = 0.31)。两组患者的主要和次要结果无明显差异:结论:对于冠状动脉异位/动脉瘤的急性冠状动脉综合征患者,在PCI期间使用肾支架具有与BMCS相似的疗效和中期随访结果。这些研究结果支持在必要时将肾支架用于异位和动脉瘤性冠状动脉:本研究已在 ClinicalTrials.gov (NCT05410678) 上注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Safety and efficacy results of percutaneous renal stent implantation in patients with acute coronary syndrome with ectatic and aneurysmatic coronary arteries.

Background: For the treatment of stenotic lesions developing in dilated coronary arteries, it is difficult to find an appropriately sized coronary stent given that the vessel diameter is too large. This poses a greater problem, especially in patients who require urgent intervention, such as acute coronary syndrome.

Objective: We aimed to evaluate the efficacy and safety of renal stents implanted in ectatic/aneurysmatic coronary arteries in such patients.

Methods: In total, 18 patients (renal stent group) who underwent renal stent implantation in ectatic/aneurysmatic coronary arteries requiring percutaneous coronary intervention (PCI) and 45 patients who underwent large-sized bare-metal coronary stent (BMCS) implantation (BMCS group) at our center were included in the study. The primary endpoints were MACE (myocardial infarction and cardiovascular mortality), and the secondary endpoints were restenosis and all-cause mortality.

Results: In the study patients with a mean follow-up of 25.3 ± 14.6 months (1-48 months), the control coronary angiography duration was 24.6 ± 14.8 months for the renal stent group and 22.8 ± 15.7 months for the BMCS group (p = 0.06). The MACE was observed in 2 (11.1%) patients in the renal stent group and 4 (8.9%) patients in the BMCS group (HR: 1.39 (0.24-7.82), p = 0.70). The secondary composite outcome was identified in 4 (22.2%) patients in the renal stent group and 6 (13.7%) patients in the BMCS group (HR: 1.93 (0.53-6.91), p = 0.31). No significant differences in primary and secondary outcomes were noted between the groups.

Conclusion: Renal stents used during PCI in patients with acute coronary syndrome with ectatic/aneurysmatic coronary arteries have similar efficacy, and mid-term follow-up results those noted for BMCS. These findings support that renal stents can be used in ectatic and aneurysmatic coronary arteries when necessary.

Clinical trial registration: This study has been registered on ClinicalTrials.gov (NCT05410678).

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