Objective: To investigate the clinical safety and mid-and short-term efficacy of rapamycin eluting stent(Excel) in patients with coronary artery disease.Methods: Between Jul.2006 and Jun.2009, 240 patients of coronary heart disease received percutaneous coronary intervention(PCI) with Excel stent and were followed up from 6 to 24 months for observing the incidence of angina pectoris, myocardial infarction, sudden death and revascularization.Results: 327 pieces of Excel stent were implanted in 272 target lesions(269 with de novo and 3 of restenosis) Two cases failed due to seriously deformed middle anterior descending artery from calcification in 1 and the angle of middle circumflex branch larger than 90 degrees causing difficult passage in another.99％ of the stents were successfully implanted, and the postoperative follow-up in the 8th to 18th month showed that angina pectoris occurred in 5, restenosis in 2 and normal in 3 by coronary arteriongraphy, suspected thrombosis in 1 at the 5th month after the operation regarding ventricular fibrillation, hemorrhage of upper digestive tract in 4 at the 6th month of the intervention, in which 1 underwent inpatient therapy with blood transfusion.The major coronary postoperative adverse event accounted for 4.58％ between 6 and 24 months.Conclusion: Excel drug-eluting stent may be excellent in treatment of coronary artery diseases with regard to its.safety and mid-and short-term effect.%目的:探讨国产 Excel雷帕霉素药物洗脱支架对冠心病患者介入治疗的安全性和近中期疗效.方法:2006年 7月～ 2009年 6月共对 240例冠心病患者进行介入治疗.术后随访 6～24个月,观察有无心绞痛、心肌梗死、猝死及再次血管重建事件.结果:272处病变血管(de novo病变269处,再狭窄病变3处)共使用 327枚 Excel支架,成功置入支架325枚,2例患者支架置入失败(1例前降支近中段病变严重钙化扭曲,支架不能通过病变;1例回旋支中段病变成角大于90度,支架不能通过成角血管),置入支架成功率99%,5例分别于术后8～18个月出现心绞痛症状,复查造影发现2例发生支架内再狭窄,3例血管造影未见支架再狭窄.1例术后5个月出现疑似晚期支架血栓形成(发生心室颤动).4例患者术后6个月左右发生上消化道出血,其中1例住院输血治疗.术后 6～24个月内主要不良反应事件发生率4.58%.结论:Excel雷帕霉素药物洗脱支架治疗冠心病,具有良好的安全性和满意的近中期临床效果.
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