Goudreau E, DiSciascio G, Kelly K, Vetrovec G W, Nath A, Cowley M J
Department of Medicine, Medical College of Virginia, Richmond 23298.
Am Heart J. 1991 Jan;121(1 Pt 1):12-9. doi: 10.1016/0002-8703(91)90949-i.
From January 1983 through December 1987, 98 patients underwent angioplasty of at least one diffusely diseased coronary artery. Diffuse coronary disease was described as: group I, narrowing greater than or equal to 50% that involved the entire vessel (40 patients), group II, long lesions greater than or equal to 2 cm in length (39 patients), group III, three or more lesions in the same vessel (19 patients). There were 65 men and 33 women, with a mean age of 60 years; 64 patients (65%) had unstable angina, 23 patients (23%) were diabetic, 31 (32%) had prior myocardial infarctions, and 12 had prior bypass surgery. Multivessel disease was present in 89% of patients. Angioplasty of only the diffusely diseased vessel was performed in 41 patients, and additional vessels were dilated in 57 patients. Overall, of 396 lesions (four per patient) and 197 vessels (two per patient) attempted, success was achieved in 382 lesions (96%) and 187 vessels (95%); angiographic success was achieved in 112 of 120 diffusely diseased vessels (93%). Clinical success was achieved in 91 patients (93%). The overall complication rate (death, myocardial infarction, urgent bypass surgery) was 8% (8 of 98): six patients (6%) had myocardial infarction (one Q wave, five non-Q wave), one patient (1%) had urgent bypass surgery, and two patients (2%) died (one during bypass surgery). The majority of complications (7 of 8 or 87%), including the two deaths, occurred in group I patients, with a 17.5% rate, versus 2.5% in group II and 0% in group III, p less than 0.002.(ABSTRACT TRUNCATED AT 250 WORDS)
从1983年1月至1987年12月，98例患者接受了至少一条弥漫性病变冠状动脉的血管成形术。弥漫性冠状动脉疾病分为：第一组，狭窄大于或等于50%累及整个血管（40例患者）；第二组，长度大于或等于2 cm的长病变（39例患者）；第三组，同一血管中有三个或更多病变（19例患者）。患者中男性65例，女性33例，平均年龄60岁；64例患者（65%）有不稳定型心绞痛，23例患者（23%）患有糖尿病，31例（32%）有过心肌梗死，12例有过搭桥手术史。89%的患者存在多支血管病变。41例患者仅对弥漫性病变血管进行了血管成形术，57例患者还对其他血管进行了扩张。总体而言，在尝试治疗的396处病变（每位患者4处）和197条血管（每位患者2条）中，382处病变（96%）和187条血管（95%）获得成功；120条弥漫性病变血管中有112条（93%）获得血管造影成功。91例患者（93%）获得临床成功。总体并发症发生率（死亡、心肌梗死、急诊搭桥手术）为8%（98例中的8例）：6例患者（6%）发生心肌梗死（1例Q波型，5例非Q波型），1例患者（1%）进行了急诊搭桥手术，2例患者（2%）死亡（1例在搭桥手术期间）。大多数并发症（8例中的7例或87%），包括2例死亡，发生在第一组患者中，发生率为17.5%，而第二组为2.5%，第三组为0%，p<0.002。（摘要截取自250字）
