Mattos L A, Sousa A G, Campos Neto C M, Labrunie A, Alves C R, Feres F, Soares Neto M M, Saad J
Arq Bras Cardiol. 2001 Jun;76(6):483-95. doi: 10.1590/s0066-782x2001000600006.
We conducted a comparative analysis of the in-hospital outcomes of patients who underwent primary percutaneous transluminal angioplasty (PTCA) or stent implantation because of an acute myocardial infarction (AMI) related to an acute vein graft occlusion.
Since 1991 the Brazilian Society of Hemodynamic and Interventional Cardiology has maintained a large database (CENIC). From these, we selected all consecutive patients, who underwent primary PTCA or stenting in the first 24 hours of AMI, with the target vessel being an occluded vein graft. Immediate results and major coronary events occurring up until hospital discharge were analyzed.
During this period, 5,932 patients underwent primary PTCA or stenting; 158 (3%) of the procedures were performed because of an acute vein graft occlusion. Stenting was performed in 74 (47%) patients. Patients treated with stents had a higher success rate and lower mean residual stenosis compared with those who underwent primary balloon PTCA. The incidence of reinfarction and death were similar for stenting and balloon PTCA.
Primary percutaneous treatment of AMI related to acute vein graft occlusion is still an uncommon practice. Primary stenting improved luminal diameter and offered higher rates of success; however, this strategy did not reduce the in-hospital reinfarction and death rate, compared with that occurring with PTCA treatment.
我们对因急性静脉移植物闭塞导致急性心肌梗死（AMI）而接受初次经皮腔内血管成形术（PTCA）或支架植入术的患者的院内结局进行了比较分析。
自1991年以来，巴西血液动力学和介入心脏病学会维护了一个大型数据库（CENIC）。我们从这些数据中选取了所有在AMI发病后24小时内接受初次PTCA或支架置入术且靶血管为闭塞静脉移植物的连续患者。分析了即刻结果以及直至出院时发生的主要冠状动脉事件。
在此期间，5932例患者接受了初次PTCA或支架置入术；其中158例（3%）手术是因急性静脉移植物闭塞而进行的。74例（47%）患者接受了支架置入术。与接受初次球囊PTCA的患者相比，接受支架置入术的患者成功率更高，平均残余狭窄更低。支架置入术和球囊PTCA的再梗死和死亡率相似。
对与急性静脉移植物闭塞相关的AMI进行初次经皮治疗仍然是一种不常见的做法。初次支架置入术改善了管腔直径并提供了更高的成功率；然而，与PTCA治疗相比，这种策略并未降低院内再梗死和死亡率。
