Hatrick Robert I, Ormiston John A, Ruygrok Peter N, Stewart James T, Webber Bruce, Gonzales Hector, Webster Mark W I
Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
EuroIntervention. 2009 May;5(1):121-6. doi: 10.4244/eijv5i1a19.
Limited data are available on the changes that occur at the dilated site many years after coronary balloon angioplasty. The development of bioabsorbable stents may increase the importance of understanding the long term changes that occur in an unscaffolded coronary artery following balloon-mediated injury.
This study evaluated, by serial quantitative angiography, the natural history of changes that occurred in the dilated segment between early (mean seven months), late (mean 4.5 years) and very late (mean 17 years) follow-up after balloon angioplasty. Of 127 consecutive patients (174 lesions) with successful coronary angioplasty, 125 underwent early, 84 late and 47 very late angiographic follow-up (75% of eligible survivors). The mean lesion diameter stenosis decreased from 36+/-11% at early to 26+/-15% at late follow-up (p<0.0001), and then increased again to 35+/-25% by very late follow-up (p=0.003). Although stenosis severity at early follow-up angiography predicted lesion regression at late follow-up, there was no significant correlation between late and very late follow-up lesion severity.
After coronary angioplasty, lesion regression at the dilated site from 7 months to 4.5 years is followed by slow lesion progression over the next 12 years.
关于冠状动脉球囊血管成形术多年后扩张部位发生的变化，可用数据有限。生物可吸收支架的发展可能会增加了解球囊介导损伤后无支架冠状动脉发生的长期变化的重要性。
本研究通过系列定量血管造影评估了球囊血管成形术后早期（平均7个月）、晚期（平均4.5年）和极晚期（平均17年）随访时扩张节段变化的自然病程。在127例连续成功进行冠状动脉血管成形术的患者（174处病变）中，125例接受了早期血管造影随访，84例接受了晚期随访，47例接受了极晚期随访（占 eligible survivors的75%）。平均病变直径狭窄率从早期的36±11%降至晚期随访时的26±15%（p<0.0001），然后在极晚期随访时再次升至35±25%（p=0.003）。尽管早期随访血管造影时的狭窄严重程度可预测晚期随访时病变的消退，但晚期和极晚期随访时的病变严重程度之间无显著相关性。
冠状动脉血管成形术后，扩张部位的病变在7个月至4.5年时会消退，随后在接下来的12年中病变进展缓慢。
