Objective:Confirming complete neointimal coverage after implantation of drug-eluting stent(DES)is clinically important because incomplete stent coverage is maybe responsible for late thrombosis and sudden cardiac death.Optical coherence tomography(OCT)is a high-resolution(≈10 μm)imaging technique capable of detecting a thin layer of neointimal hyperplasia(NIH)inside DES.Helios stent system(KinheIy Bio-tech Co(Shenzhen).Ltd)is a new generation of sirolimus eluting stents.Methods:Motorized optical coherence tomographic pullback was performed at 9-month follow-up to examine consecutive Helios stent mplantations in 10 patients.NIH thickness inside each strut and NIH area percentage inside each cross-section were measured.Results:In total,2063 struts in 296 mm stented segments were analyzed.Overall,NIH thickness were(95.7±66.62)μm,rates of exposed struts was 60.2% and the average NIH area percentage was 5.0618% ± 5.6625%.Conclusion:Our study suggests that dual antiplatelet therapy after Helios stent implantation must be continued at least 9months after DES implantation.
目的针对经皮冠状动脉介入治疗后并发致死性肺栓塞的患者,探讨其临床转归和处理方法。方法选择我科6年来所有冠状动脉介入术后并发致死性肺栓塞的病例,观察其发生、发展和转归。结果共7例患者(男5例,女2例)冠状动脉介入术后并发致死性肺栓塞;平均年龄(55.9±11.7)岁;其中单纯冠状动脉造影5例,介入治疗2例;所有患者均表现为冠状动脉介入术24 h 后下地时或排便时突发呼吸心跳停止。经紧急心肺复苏,除颤后仍直接死亡3例,4例恢复呼吸心跳。恢复呼吸心跳患者均行溶栓治疗,最终脑死亡1例,好转后出院3例,该3例经过6个月～6年随访均症状稳定,无再发肺栓塞。结论经皮冠状动脉介入治疗后致死性肺栓塞的发生罕见,急性期预后极差,如果抢救成功,远期预后较好。
