Suzuki S, Kumamaru H, Ariizumi T, Fujimura T, Nishikawa K, Chino M, Misumi T, Okura M, Katogi T, Soma Y
Department of Cardiovascular Surgery, Ashikaga Red Cross Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Mar;40(3):368-74.
A total of 230 vein grafts were studied angiographically in 116 unselected survivors of 260 coronary bypass operations performed from May 1977 through October 1989 in order to investigate atherosclerotic changes in coronary vein grafts after operation. These patients were divided into three groups according to the interval from operation to angiography. In group A (30 patients) the interval was less than one year (mean interval 8.2 months), in group B (73 patients) from one to five years (mean interval 19.2 months) and in group C (13 patients) more than 5 years (mean interval 96.6 months). Fifty-five vein grafts were in group A, 153 vein grafts in group B and 22 vein grafts in group C. The graft patency rate of each group was 83.6%, 89.5% and 90.9% respectively (N.S.). To classify angiographic appearances we believe to be caused by atherosclerosis, we devised a grading system. Category I indicated that the graft outline was completely smooth without any irregularity; Category II indicated that less than 50% of the estimated surface area of the graft intima was irregular; Category III indicated that more than 50% of the intima was involved. Significant stenosis indicated narrowing reducing the lumen to less than 50% of the graft. Of the 203 patent grafts 181 grafts (89%) were in Category I, 22 grafts (11%) in Category II, but no graft in Category III. In group A of the 46 patent grafts 45 grafts (98%) were classified as Category I and 1 graft (2%) was classified as Category II.(ABSTRACT TRUNCATED AT 250 WORDS)
为研究冠状动脉搭桥术后静脉移植物的动脉粥样硬化变化,对1977年5月至1989年10月间进行的260例冠状动脉搭桥手术的116例未经挑选的存活者的230条静脉移植物进行了血管造影研究。根据手术至血管造影的间隔时间,将这些患者分为三组。A组(30例患者)间隔时间少于1年(平均间隔8.2个月),B组(73例患者)间隔时间为1至5年(平均间隔19.2个月),C组(13例患者)间隔时间超过5年(平均间隔96.6个月)。A组有55条静脉移植物,B组有153条静脉移植物,C组有22条静脉移植物。每组的移植物通畅率分别为83.6%、89.5%和90.9%(无显著差异)。为对我们认为由动脉粥样硬化引起的血管造影表现进行分类,我们设计了一个分级系统。I类表示移植物轮廓完全光滑,无任何不规则;II类表示移植物内膜估计表面积不到50%不规则;III类表示超过50%的内膜受累。显著狭窄指管腔缩小至移植物管腔的50%以下。在203条通畅的移植物中,181条移植物(89%)为I类,22条移植物(11%)为II类,但无III类移植物。在A组的46条通畅移植物中,45条移植物(98%)被分类为I类,1条移植物(2%)被分类为II类。(摘要截短于250字)