Ciampricotti R, el Gamal M, Relik T, Bonnier J, Michels R
Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
Int J Cardiol. 1991 Oct;33(1):27-31. doi: 10.1016/0167-5273(91)90148-i.
Percutaneous transluminal angioplasty of coronary stenoses distal to anastomosis of a venous graft was attempted through the graft 22 times in 19 patients. Ten patients had stable angina, seven unstable angina and two patients acute myocardial infarction. The mean interval between bypass surgery and angioplasty was 6.5 years (range 1-15). Fifteen lesions were dilated in the left anterior descending artery, five in the right coronary artery, and two in the circumflex artery. Three procedures were for double lesions. In two cases, a stenosed vein graft was also dilated. All grafts were cannulated with an El Gamal guiding catheter. The procedure failed in two cases. The remaining 20 lesions were successfully dilated. Early and late occlusion of the graft occurred in one patient, and coronary arterial stenosis recurred in two patients. All three patients underwent successful redilatation. The 17 patients undergoing successful dilatation were asymptomatic, with a normal exercise test and/or maintained angiographic result at follow-up of 14 months mean duration (range 2-48). Angioplasty of coronary stenosis through a vein graft is feasible, safe and effective. This therapeutic approach avoids the need for repeat bypass surgery and, as judged by long-term follow-up, has a favourable clinical outcome.
在19例患者中，通过静脉移植物对吻合口远端的冠状动脉狭窄进行了22次经皮腔内血管成形术。10例患者为稳定型心绞痛，7例为不稳定型心绞痛，2例为急性心肌梗死。搭桥手术与血管成形术之间的平均间隔时间为6.5年（范围1 - 15年）。15处病变位于左前降支动脉，5处位于右冠状动脉，2处位于回旋支动脉。3次手术针对双病变。2例患者中，狭窄的静脉移植物也进行了扩张。所有移植物均使用El Gamal引导导管插管。2例手术失败。其余20处病变成功扩张。1例患者出现移植物早期和晚期闭塞，2例患者冠状动脉狭窄复发。所有3例患者再次扩张均成功。17例成功扩张的患者无症状，运动试验正常和/或在平均14个月（范围2 - 48个月）的随访中血管造影结果保持良好。通过静脉移植物对冠状动脉狭窄进行血管成形术是可行、安全且有效的。这种治疗方法避免了重复搭桥手术的需要，并且根据长期随访判断，具有良好的临床结果。
