刘曦,张海涛

• 1:中国医学科学院阜外心血管病医院冠心病诊治中心

摘要(Abstract)：

冠状动脉支架断裂是冠脉支架置入的并发症之一,其危险因素包括血管因素、支架因素及操作因素。目前其发生机制尚不明确,虽然支架断裂可以引发支架再狭窄及支架内血栓形成等情况,但未增加临床事件,尤其是致死性事件的发生率。针对支架断裂的处理决策可以采用强化抗血小板药物治疗、球囊扩张术、再次置入支架及外科手术治疗。

关键词(KeyWords)： 支架断裂;冠状动脉介入治疗;支架再狭窄

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘曦,张海涛

参考文献(References)：

• [1]Chowdhury PS,Ramaos RG.Images in clinical medicine.Coronary-stent fracture[J].N Engl J Med,2002,347(8):581.
• [2]Tizón-Marcos H,De Larochellière R,Larose E,et al.Breakpoint:left main stent fracture-review of the literature[J].J Interv Cardiol,2009,22(4):362-367.
• [3]Aoki J,Nakazawa G,Tanabe K,et al.Incidence and clinical impact of coronary stent fracture after sirolimus-eluting stent implantation[J].Catheter Cardiovasc Interv,2007,69(3):380-386.
• [4]Okumura M,Ozaki Y,Ishii J,et al.Restenosis and stent fracture following sirolimus-eluting stent(SES)implantation[J].Circ J,2007,71(11):1669-1677.
• [5]Umeda H,Gochi T,Iwase M,et al.Frequency,predictors and outcome of stent fracture after sirolimus-eluting stent implantation[J].Int J Cardiol,2009,133(3):321-326.
• [6]Yang TH,Kim DI,Park SG,et al.Clinical characteristics of stent fracture after sirolimus-eluting stent implantation[J].Int J Cardiol,2009,131(2):212-216.
• [7]Kim HS,Kim YH,Lee SW,et al.Incidence and predictors of drug-eluting stent fractures in long coronary disease[J].Int J Cardiol,2009,133(3):354-358.
• [8]Nakazawa G,Finn AV,Vorpahl M,et al.Incidence and predictors of drug-eluting stent fracture in human coronary artery:a pathologic analysis[J].J Am Coll Cardiol,2009,54(21):1924-1931.
• [9]Serikawa T,Kawasaki T,Koga H.Impressive sirolimus-eluting stent fracture immediately after stent implantation:a case report[J].Int J Cardiol,2009,134(3):e113-e116.
• [10]Doi H,Maehara A,Mintz GS,et al.Classification and potential mechanisms of intravascular ultrasound patterns of stent fracture[J].Am J Cardiol,2009,103(6):818-823.
• [11]Lee MS,Jurewitz D,Aragon J,et al.Stent fracture associated with drug-eluting stents:clinical characteristics and implications[J].Catheter Cardiovasc Interv,2007,69(3):387-394
• [12]Scheinert D,Scheinert S,Sax J,et al.Prevalance and clinical impact of stent fractures after femoropopliteal stenting[J].J Am Coll Cardiol,2005,45(2):312-315.
• [13]Shaikh F,Maddikunta R,Dielmami-Hani D,et al.Stent fracture,an incidental finding or a significant marker of clinical In-stent restenosis?[J].Catheter Cardiovasc Interv,2008,71(5):614-618
• [14]Tandar A,Whisenant BK,Michaels AD.Stent fracture following stenting of a myocardial bridge:report of two Cases[J].Catheter Cardiovasc Interv,2008,71(2):191-196.
• [15]Marreya RV,Burgermeister R,Grishaber RB,et al.Fatigue and life prediction for cobalt-chromium stents:A fracture mechanics analysis[J].Biomaterials,2006,27(9):1988-2000.
• [16]Kim EJ,Rha SW,Wani SP,et al.Coronary stent fracture and restenosis in the drug-eluting stent era:Do wehave clues of management?[J].Int J Cardiol,2007,120(3):417-419.
• [17]Morice MC,Colombo A,Meier B,et al.Sirolimus-vs paclitaxel-eluting stents in de novo coronary artery lesions:the REALITY trial:a randomized controlled trial[J].JAMA,2006,295(8):895-904.
• [18]Cosgrave J,Melzi G,Corbett S,et al.Comparable clinical outcomes with paclitaxel-and sirolimus-eluting stents in unrestricted contemporary practice[J].J Am Coll Cardiol,2007,49(24):2320-2328.
• [19]Yamada KP,Koizumi T,Yamaguchi H,et al.Serial angiographic and intravascular ultrasound analysis of late stent strut fracture of sirolimus-eluting stents in native coronary arteries[J].Int J Cardiol,2008,130(2):255-259.
• [20]Shinde RS,Hardas S,Grant PK,et al.Stent fracture detected with a novel fluoroscopic stent visualization technique–StentBoost[J].Can J Cardiol,2009,25(8):487.
• [21]Mitsutake R,Miura S,Nishikawa H,et al.Usefulness of the evaluation of stent fracture by64-multi-detector row computed tomography[J].J Cardiol,2008,51(2):135-138.
• [22]Aoki J,Nakazawa G,Tanabe K,et al.Incidence and clinical impact of coronary stent fracture after sirolimus-eluting stent impantation[J].Catherter Cardiovasc Interv,2007,69(3):380-386.
• [23]Stambuk K,Pavlovi N,Gabri ID,et al.Coronary artery stent fracture with in-stent restenosis and aneurysm formation:diagnosis and successful treatment with graft stent implantation[J].Int J Cardiol,2011,148(2):253-255.
• [24]Freixa X,Almasood AS,Khan SQ,et al.Decreased risk of stent fracture-related restenosis between paclitaxel-eluting stents and sirolimus eluting stents:results of long-term follow-up[J].Catheter Cardiovasc Interv,2011,79(4):559-565.
• [25]Zaizen H,Tamura A,Miyamoto K,et al.Complete fracture of sirolimus-eluting stent detected by multislice computed tomography[J].Int J Cardiol,2007,118(1):120-121.
• [26]Lee MS,Jeong MH,Kim IS,et al.Clinical outcomes and optimal treatment for stent fracture after drug-eluting stent implantation[J].J Cardiol,2009,53(3):422-428.