https://scholars.lib.ntu.edu.tw/handle/123456789/187243
標題: | Phosphorylcholine-Coated Dexamethasone Eluting Stent in the Prevention of Restenosis: A Randomized Trial in a Single Hospital | 作者: | LI, AI-HSIEN LIAU, C.-S. YEIH, D.-F. CHU, S.-H. |
關鍵字: | in-stent restenosis;drug eluting stents;dexamethasone | 公開日期: | 2007 | 卷: | v.23 | 期: | n.1 | 起(迄)頁: | 35-42 | 來源出版物: | ACTA CARDIOLOGICA SINICA | 摘要: | Background/Purpose: In-stent restenosis (ISR) occurs in approximately 20% of the patients undergoing coronary stenting. Post-stenting inflammation may be among the major pathogenetic mechanisms in which vascular reactions produce intimal hyperplasia and smooth muscle cell migration. The objective of this open-label randomized controlled study was to evaluate the effect of phosphorylcholine-coated stents treated with dexamethasone to prevent ISR. Method. We evaluated 17 discrete coronary lesions with a stenosis diameter > 70% from 13 patients. The diameter of the reference vessels ranged from 2.7 mm to 3.7 mm (mean 3.18 +/ - 0.31 mm). Using open- label randomization, 9 lesions were assigned to the control group and implanted with un-coated bare-metal stents. The remaining lesions were treated with dexamethasone-treated phosphoryleholine-coated stents. All patients were followed clinically and/or angiographically. Result: One patient died from a nontreatment-related event one week after the procedure. Four patients, two each in the dexamethasone group and the control group, refused to have a follow-up coronary angiography (CAG), however, three of those patients refusing CAG had a thallium myocardial perfusion study. Of these patients, 2 in control group showed myocardial perfusion impairment. In the remaining 12 lesions in 7 patients, the diameter of the stenosis was smaller in the dexamethasone group versus the control group, although the difference was not significant statistically ( 0.33 +/- 0.22 versus 0.22 +/- 0.06 mm, p = 0.352). There was a tendency toward a higher binary restenosis rate in the control group versus the dexamethasone group (33% vs. 0%, p = 0.202). When the angiographic and clinical restenosis rates were combined, the control group had a significantly higher restenosis rate than the dexamethasone group (44.4% vs. 0% p = 0.042). One patient from the control group underwent target lesion revascularization. Conclusion: Results of this study suggest that dexamethasone-eluting stents may have a potential role in the prevention of ISR in patients with coronary artery stents implanted. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/88179 |
顯示於: | 醫學系 |
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