在人类致命的晚期冠状动脉支架血栓形成的病理机制
Andrew Farb1, Allen P Burke, Frank D Kolodgie
1Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Circulation
|September 25, 2003
概括
晚期支架血栓塞 (LST) 是冠状动脉支架后的一种严重并发症. 关键原因包括穿过分支骨的支架和受损的愈合,增加致命事件的风险.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 病理学 病理学 病理学
背景情况:
- 冠状动脉支架部署是一种常见的手术,急性血栓形成的风险较低.
- 晚期支架血栓瘤 (LST),发生在30天后,是未被认可的,缺乏详细的病理描述.
研究的目的:
- 调查晚期支架血栓瘤 (LST) 的临床和病理特征.
- 确定冠状动脉支架后导致LST发生的因素.
主要方法:
- 对提交病理检查的人类冠状动脉支架注册表的分析.
- 鉴定和审查13个LST病例,定义为急性血栓在支架植入后>或=30天内.
主要成果:
- LST发生在植入后平均3.6个月,导致10例突然心脏病死亡.
- 确定的病理机制包括穿过分支骨的支架,放射治疗,斑块破坏,斑块脱落和新极限愈合的失败.
- 在LST病例中,只有31%的病例存在静脉静脉复缩,在12例病例中观察到受损的内脏愈合.
结论:
- 晚期支架血栓形成是冠状动脉支架的潜在致命并发症.
- 诸如穿过分支骨架的支架,放射治疗,斑块破坏和落等因素可以导致LST.
- 在支架支架上不完全的新理想愈合会延长血栓风险的时期.
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