1.Effect of Sirolimus-eluting stent in actual clinical practice
Shuzheng LV ; Yundai CHEN ; Xin CHEN
Chinese Journal of Interventional Cardiology 1993;0(02):-
Objective To sbserve the effect of sirolimus-eluting stent in actual clinical practice. Methods The study included 263 patients who had implanted the cypher stents from December 2002 to May 2004. The incidence of MACE was followed up in all patients 8?2 months after stent implantation by means of telephone or out-patient department visit. Evaluation of the therapeutic effect was also made in the diabetes subgroup and different types of lesions, including left main, bifurcation, chronic total occlusion, diffuse disease, in-stent restenosis, littlie vessel, acute occlusion, ostial lesions, and just A-type lesions. The rate of restenosis was observed in all of the lesion. Results Among 246 patients, all patients were successfully implanted with the cypher stents, 93.5% patients had been followed up, 10 (3.8%) patients had MACE. 139 (52.6%) patient were revised by angiography. The total rate of restenosis was 10.1%, and among it 12.9% was diabetes mellitus patients, 11.1% with chronic total occlusion, 11.3% with little vessel lesion, 10.0% with diffuse lesion, 22.2% with left main lesion, 18.1% with bifurcation, 11.1 with CTO 9.1% with ostial lesions, and 8.7% with A-type lesion lesion. Conclusion Cypher stent implantion was safe and effective in actual clinical proctice. The incidence rate of MACE was low in lesions such as chronic total occlusion, diffuse disease, in-stent restenosis, littlie vessel, acute occlusion, ostial lesions, and A-type lesion. It may be beneficial for patients who had left main, bifurcation, in-stent restenosis.
2.Clinical outcomes of unrestricted application of domestic Sirolimus-eluting stent
Xin CHEN ; Shuzheng LU ; Yundai CHEN
Chinese Journal of Interventional Cardiology 2003;0(06):-
Objective To ivestigate the clinical outcomes of domestic Sirolimus-eluting stents(Partner stents)in unselected patients.Methods We reviewed the clinical data of 516 patients who had implanted the Paterner stents during August 2006 to Dotober 2007.We followed up all the patients by telephon or by clinical visits for(9?2)months.The incidence of MACE and the result of follow up angiogram was analysed.Further investigation was made in the relation between the restenosis rate and lesion morphorlogy.Results A total of 872 Partner Stents were implanted successfully in 516 patients.Among them,482 patients(93.4%)finished the clinical follow up and 239 patients(46.3%)received follow up angiogram.The MACE rate was 3.5% and the restenosis rate was 11.3% as share in angiogram.A 14% of the patients with reslenosis was concomitant with diabetes mellitus.We analysised the rate of restenoses of left main,bifurcation,chronic total occlusion,diffuse disease,in-stent restenoses,littile vessal,acute occlusion,ostial lesions,and just A-just lesion.Conclusion Implantation of domestic Partner stent was safe and effective,even in patients with diabetes mellitus.The MACE rate was low and the stent has shown satisfactory ontcomes in lesions such as left main,bifurcation,chronic total occlusion,diffuse disease,in-stent restenoses,littile vessal,acute occlusion,ostial lesions,and A-type lesion.
3.Analysis of acute and subacute stent thrombosis after successful implantation of sirolimus-eluting stent in complex coronary lesions
Xiantao SONG ; Yundai CHEN ; Shuzheng LU
Chinese Journal of Interventional Cardiology 1993;0(03):-
Objective Current data on stent thrombosis(ST) in drug-eluting stent(DES) have come from randomized trials with strict entry criteria,which limits their generalizability to daily practice.The study sought to determine the real-world incidence of angiographically confirmed and possible stent thrombosis(ST) in an unrestricted population during the first 30 days after sirolimus-eluting stent(SES) implantation.Methods A cohort of consecutive complex patients treated with SES implantation was selected from Sep,2002 to May,2005.A total of 796 subjects entered the study.Results In the first 30 days after SES implantation,1 case had acute stent thrombosis and seven other cases had subacute stent thrombosis.Among these eight patients,ST presented as STEMI in three patients,NSTEMI in four patients and UAP only in one patient.Bifurcation stenting and long lesion stenting were the two significant risk factors(OR was 11.2 and 8.6 respectively,95% CI was 4.1 to 30.8 and 1.9 to 17.2 respectively,P
4.Clinical evaluation of the dexamethasone coated stent in coronary small vessel disease
Yundai CHEN ; Shuzheng LV ; Rui TIAN
Chinese Journal of Interventional Cardiology 1993;0(03):-
ObjectiveTo evaluate the clinical results of intracoronary implantation of the phosphorylcholine dexamethasone coated biodivysio small coronary stents. Methods Prospective analyses of long-term results of the phosphorylcholine dexamethasone coated biodivysio coronary stents, and their implantation performed on 82 coronary artery disease patients were conducted. We implanted 106 stents of which 54 were the phosphorylcholine dexamethasone coated biodivysio coronary stents, and 52 the phosphorylcholine coated biodivysio coronary stents. Results The success rate of the implantation of both groups was 100%. The major adverse cardiac events (MACE) of the 3-month follow-up in the phosphorylcholine dexamethasone coated biodivysio coronary stents group were 9.8%; and in the phosphorylcholine coated biodivysio coronary stents group were 22.0%. The restenosis rate of the 8-month follow-up in the phosphorylcholine dexamethasone coated biodivysio coronary stents group was 4.9%; and in the phosphorylcholine coated biodivysio coronary stents group was 23.0%. Conclusion The implantation of the phosphorylcholine dexamethasone coated biodivysio coronary stents is a safe and efficient interventional procedure with a high success rate and few MACE. It may reduce restenosis rate.
5.Evaluation of varions therapies in patients with acute ST segment elevation myocardial infarction who arrived at hospitals within 12 hours from the onset of chest pain
Yundai CHEN ; Xiantao SONG ; Shuzheng LV
Chinese Journal of Interventional Cardiology 1996;0(01):-
75 yrs), presence of DM etc. (2) In our study, even though the door-to-ballon time was longer than the door-to-needle time, the therapentic outcome of primary PCI was better than that of thrombolysis. (3) There are improving room for guidelines application of reperfusions such as fibrinolytic and primary PCI, aspirin, ACEI, ?-blockers and cholesterol lowering agents in patients with acute ST segment elevation myocardial infarction in China.
6.Feasibility analysis of coronary angiography by transradial approach with 4 F catheter
Xiaofan WU ; Yundai CHEN ; Shuzheng LV
Chinese Journal of Interventional Cardiology 1993;0(02):-
Objective To assess the feasibility of coronary angiography by transradial approach with 4 F catheter.Methods The procedural details, picture quality and local complication of coronary angiography by transradial approach with 4 F catheter in 138 patients were recorded and analyzed. Results The success rate of angiography was 97.7%. Mean fluoroscopy time was 5.05?3.23 minutes with total procedural time was 20.51?3.37 minutes. The incidence of dislodgement and excessive engagement of either coronary artery was 7.8% and 9.4% repectively. The angiographic scores for left anterior descending, circumflex and right coronary arteries were 2.87?0.40, 2.88?0.39, 2.90?0.35, respectively. Vasospasm occurred in 6 cases in the radial artery and in another 2 cases in the coronary artery. There were no occlusion of radial artery found during follow up. Conclusion Four-F catheter could be utilized in selected patients for its nice maneuverability, fine images and less vascular complications during angiography.
7.Comparison of coronary artery bypass graft with percutaneous coronary intervention with bare mental stents or sirolimus eluting stents for left main coronary artery disease
Yun LIN ; Yundai CHEN ; Xiantao SONG
Chinese Journal of Interventional Cardiology 1996;0(04):-
Objective To evaluate the clinical outcomes of consecutive unselected patients treated with coronary artery bypass graft surgery or percutaneous coronary intervention with bare mental stents or sirolimus eluting stents for left main artery disease。Methods From 1995 to 2005,415 patients with left main artery disease received revascularization therapies in which 196 subjects received CABG procedure,and 97 subjects received BMS therapies from October,1995 to August,2003,and 122 subjects received SES therapies from September,2003 to May,2005.Results Rate of diabetes mellitus cormorbidity in CABG group was higher than that in BMS group and SES group,but the cormorbidity rates of renal insufficiency,stroke and pulmonary insufficiency in CABG group were lower than those in BMS group and SES group.The 30-day major adverse cardiac and cerebrovascular events in BMS group,SES group and CABG group was 3.09%,4.01% and 10.71% respectively(P
8.Effect of tissue factor pathway inhibitor-1 on no-reflow phenomenon in rabbit
Jingguang LUO ; Yundai CHEN ; Changhua WANG ; Xiuxiu YANG
Chinese Journal of Emergency Medicine 2012;21(3):252-255
Objective To observe the effects of different doses of human recombinant tissue factor pathway inhibitor-1 (TFPI-1) on no-reflow (NR) phenomenon in rabbit.Methods Fifty-two New Zealand white rabbits were subjected to coronary artery occlusion for 120 min and followed by reperfusion for 60 min,and then were randomly (random number) assigned into four groups:control group,large,moderate and low doses TFPI-1 groups ( 1000 ng/kg,100 ng/kg,10 ng/kg bolus and thenl0 ng/kg,1 ng/kg and 0.1 ng/kg per minute infusion for maintenance,each group n =13).The no-reflow area (NA) and ischemic area (IA) was measured by thioflavin S and Evan's blue.The NR severity was expressed by NA/IA.The difference in NR severity was compared between groups.The thrombi and myocardial injury were observed under light microscope.The infarction and NR severity in different groups were compared by using one-way ANOVA followed by LSD procedure.Results There were no significant differences in IA and body weight among four groups (P>0.05).NR severity in the large,moderate,low doses TFPI-1 groups and control group were (0.210 ±0.061 ),(0.389 +0.110),(0.478 ±0.077) and (0.536 ±0.061 ),respectively.NR severity in the large dose TFPI-1 group was slightest among the four groups (P <0.01 ).NR severity in the moderate dose TFPI-1 group was significantly decreased than that in control group ( P < 0.01 ) and in low dose TFPI-1 group (P <0.05 ).There was no significant difference in NR severity between the low dose TFPI-1 group and control group ( P > 0.05 ).There was less thrombus formation and lower grade myocardial injury found in the large dose TFPI-1 group. Conclusion Human rTFPI-1 might lessen NR severity in rabbit in dose-dependent,suggesting the option on human rTFPI-1 for treatment of NR phenomenon.
9.The effect of recombinant human tissue factor pathway inhibitor-1 on Myocardial infarction in rabbits
Jingguang LUO ; Yundai CHEN ; Yuan Lü ; Feng TIAN ; Changhua WANG
Chinese Journal of Emergency Medicine 2011;20(5):507-510
Objective To observe the function of recombinant human tissue factor pathway inhibitor1(rTFPI-1)in acute myocardial infarction in rabbit. Method Forty New Zealand White rabbits were subjected to coronary artery occlusion for 120 min and followed by reperfusion for 60 min,then they were ranlow dose rTFPI-1 group(n=10/group).The extent of ischemic area and the extent of myocardial infarction area were measured by Evan's blue stain and TTC stain,respectively.The degrees of infarction severity and ischemic severity were expressed as the ratios of the total left ventrieular wall area.The degrees of infarction severity and ischemic severity in different groups were compared by using one-way ANOVA and then followed by LSD procedure.Results The degree of infarction severity in the larger dose rTFPI-1 group was significantly lessened than that in low dose RTFPI-1 group and control group(P<0.001),and than that in modcrate dose rTFPI-1 group as well(P<0.05).The degree of infarction severity in the moderate dose rTFPI1 group was significantly lessened than that in low dose rTFPI-1 group and control group(P<0.001).There was no significant difference in degree of infarction severity between low dose rTFPI-1 group and control group(P>0.05).Conclusions Human rTFPI-1 might decrease myocardial infarction severity and save the survival myocardial tissue.