Brack M, Mooney J F, Huber M, Gobel F L, Van Tassel R A, Mooney M R
Minneapolis Heart Institute/Abbott Northwestern Hospital, MN 55407.
J Invasive Cardiol. 1991 Jul-Aug;3(4):165-9.
The efficacy and safety of coronary angioplasty for stenoses adjacent to coronary aneurysms were studied in 25 patients (19 men and 6 women, mean age 62 +/- 11 years). The study represented 1.1% of patients undergoing coronary angioplasty during the study time period. The aneurysm diameter exceeded 1.8 +/- 0.2 times the normal artery diameter. Eleven (44%) of these aneurysms were localized in the left anterior descending, 3 (12%) in the circumflex and 11 (44%) in the right coronary artery. Percent diameter stenosis was reduced from 72 +/- 10% to 23 +/- 19%, and transstenotic gradient from 51 +/- 13 to 15 +/- 9 mmHg when measured. Clinical success (absence of pain on discharge without coronary bypass surgery, death, or infarction) was achieved in 24 (96%) patients. In one patient acute vessel closure occurred. No embolic events or coronary artery rupture occurred. Seventeen (71%) of the 24 successful patients remained asymptomatic at clinical follow-up (mean = 7.7 +/- 5.0 months). At late follow-up, one patient had sustained a myocardial infarction, two had elective bypass surgery, and two had successful repeat angioplasty. The data from this small patient population suggest that angioplasty for a stenosis adjacent to a coronary aneurysm can be performed safely with a high primary success rate.
对25例患者（19例男性，6例女性，平均年龄62±11岁）进行了冠状动脉成形术治疗冠状动脉瘤附近狭窄的疗效和安全性研究。该研究占研究时间段内行冠状动脉成形术患者的1.1%。动脉瘤直径超过正常动脉直径的1.8±0.2倍。其中11例（44%）动脉瘤位于左前降支，3例（12%）位于回旋支，11例（44%）位于右冠状动脉。测量时，直径狭窄百分比从72±10%降至23±19%，跨狭窄梯度从51±13降至15±9 mmHg。24例（96%）患者获得临床成功（出院时无疼痛，未行冠状动脉搭桥手术、死亡或梗死）。1例患者发生急性血管闭塞。未发生栓塞事件或冠状动脉破裂。24例成功患者中有17例（71%）在临床随访（平均7.7±5.0个月）时仍无症状。在后期随访中，1例患者发生心肌梗死，2例行择期搭桥手术，2例行成功的重复血管成形术。来自这一小部分患者的数据表明，冠状动脉瘤附近狭窄的血管成形术可以安全地进行，且初次成功率较高。
