| Objectives:The purpose of this study is to analyze the practicality of fine diagnosis and individualized treatment of stent restenosis cases after coronary drug eluting stent implantation using optical coherence tomography(OCT)in clinical work.Methods:Selected 13 patients who underwent coronary angiography in the Second Affiliated Hospital of Kunming Medical University from January 2019 to January 2020 to confirm the presence of restenosis in the stent after OCT detection after stent drug eluting stent implant Included in this study.All the selected patients had received coronary drug-eluting stent implantation in our hospital,and they were treated with secondary prevention of coronary heart disease following medical advice after surgery.Use OCT to measure the total stent length,minimum lumen area,nature of atherosclerotic plaque,poor stent adhesion,stent intima coverage,and thrombosis in each patient in this study.In the group,indexes such as the degree of stent restenosis,TIMI blood flow classification,and whether there is poor stent adhesion were collected;at the same time,the patient's age,gender,and stent implantation years were collected.The OCT data of patients with different years of stent implantation and different methods of treating stent restenosis were analyzed in turn.Results:1.These 13 patients were divided into two groups according to the years of coronary drug-eluting stent implantation.The years of stent implantation were less than 1 year and the years of stent implantation were more than 1 year.Among them,the minimum lumen area,fiber plaque length,and fiber plaque curvature(P values were 0.044,0.046,and 0.036,all<0.05)were statistically significant between the two groups when the coronary stent implantation period was less than 1 year and greater than 1 year difference.2.All the patients selected in this study were divided into interventional treatment of stent restenosis group and intensive drug treatment of restenosis group.Among them,the minimum lumen area,fibrous plaque thickness,lipid plaque length,and lipid plaque curvature(P values were 0.001,0.028,0.002,0.018,all<0.05)existed between the two groups Learn the differences.3.The patients were divided into two groups:simple balloon dilatation(3 cases)and drug-eluting stent re-implantation(3 cases)according to the different interventional stent restenosis protocols used.The minimum lumen area in the original stent(P value is 0.046,less than 0.05)is statistically different between the above two groups.4.Among the patients included in this study,1 case was treated with drug balloon dilatation and 1 case with cutting balloon dilation plus drug balloon dilation when treating stent restenosis.The length of fibrous plaque in the original stent and the radius of the fibrous plaque in patients with drug balloon expansion were significantly smaller than those in patients with cutting balloon expansion+drug balloon expansion;patients with drug balloon expansion had the smallest lumen area in the original stent It is larger than that of patients with cutting balloon expansion and drug balloon expansion.Conclusions:1.Obtaining the nature of the new atherosclerotic tissue in the stent through OCT has certain clinical significance for guiding the treatment of drug-eluting stent restenosis.2.The degree of fibrous plaque hyperplasia in the stent is positively correlated with the time of drug-eluting stent implantation.The longer the implantation time,the greater the degree of fibrous plaque hyperplasia.3.The clinical symptoms and the degree of hyperplasia of lipid plaques and fibrous plaques in the stent determine whether to adopt interventional methods to treat drug-eluting stent restenosis.Patients with no chest tightness and(or chest pain)symptoms and less lipid plaque and fibrous plaque hyperplasia may not use interventional therapy for stent restenosis,and only continue medical treatment. |
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