vom Dahl J, Uebis R, Meyer J, Effert S, Cramer S, Cramer C, Rupprecht H J, Nase-Hüppmeier S, Erbel R, Hanrath P
Medizinische Klinik I, RWTH, Aachen.
Z Kardiol. 1991 May;80(5):322-9.
289 consecutive patients (255 male, 34 female, 50 +/- 6 years) had an elective single-vessel-PTCA between October 1978 and March 1983. A clinical long-term follow-up was obtained after 4.7 (3-10) years. The PTCA success-rate was 73% with a non steerable balloon catheter being used in 95% of the cases. For 271/289 patients with follow-up (94%), the 56-month-survival rate was 96%, the incidence of non-fatal myocardial infarctions 11%, and the need for a second intervention (PTCA and/or bypass surgery) was 39%. The most favorable long-term outcome was observed in patients without need of a second intervention (97% survival, 7% non-fatal myocardial infarction, 83% without cardiac complaints during everyday life), and in patients with elective bypass surgery after an unsuccessful PTCA (100% survival, 5% myocardial infarction). 32/138 (23%) of patients without a second intervention during follow-up underwent an angiographic control after an average of 4.7 years. In comparison with the first follow-up angiogram 6 months after PTCA, the mean residual stenosis at the PTCA-site showed a slight decrease. It is concluded that PTCA offers good clinical and angio-graphic long-term results in single-vessel disease, with an excellent prognosis of patients without need for a second intervention.
1978年10月至1983年3月期间,289例连续患者(255例男性,34例女性,年龄50±6岁)接受了择期单支血管经皮冠状动脉腔内血管成形术(PTCA)。在4.7(3 - 10)年后进行了临床长期随访。PTCA成功率为73%,95%的病例使用了不可操纵的球囊导管。在271/289例接受随访的患者(94%)中,56个月生存率为96%,非致命性心肌梗死发生率为11%,需要二次干预(PTCA和/或搭桥手术)的比例为39%。在无需二次干预的患者(97%生存率,7%非致命性心肌梗死,83%日常生活中无心脏不适)以及PTCA失败后接受择期搭桥手术的患者(100%生存率,5%心肌梗死)中观察到了最有利的长期结果。随访期间无需二次干预的138例患者中有32例(23%)在平均4.7年后接受了血管造影复查。与PTCA后6个月的首次随访血管造影相比,PTCA部位的平均残余狭窄略有下降。结论是,PTCA在单支血管疾病中提供了良好的临床和血管造影长期结果,无需二次干预的患者预后极佳。