Schräder R, Rummel D, Sievert H, Kober G, Kaltenbach M
Abteilung für Kardiologie, Universität Frankfurt/Main.
Dtsch Med Wochenschr. 1991 Feb 8;116(6):212-6. doi: 10.1055/s-2008-1063602.
Coronary arteriography revealed severe stenoses of the proximal part of the anterior interventricular branch with normal ventricular function in two patients (aged 42 and 38 years) with stable angina and ischaemia reaction in the exercise ECG. In the first patient it was a short spur-like 80% narrowing. But percutaneous balloon angioplasty failed to change the angiographic appearance. In the other patient there was an eccentric, apparently elastic, 90% stenosis, about 10 mm long. Here, too, balloon angioplasty had failed. Subsequently directional coronary atherectomy in both patients achieved removal of the stenosis with lasting clinical improvement. Atherectomy should be considered in similar cases after failed balloon dilatation.
冠状动脉造影显示，两名患有稳定型心绞痛且运动心电图有缺血反应的患者（年龄分别为42岁和38岁），其前室间支近端严重狭窄，但心室功能正常。第一名患者为短刺状狭窄，狭窄程度达80%。但经皮球囊血管成形术未能改变血管造影表现。另一名患者为偏心性、明显有弹性的狭窄，狭窄程度达90%，长度约10毫米。此处球囊血管成形术同样失败。随后，两名患者均接受了定向冠状动脉斑块旋切术，狭窄得以消除，临床症状持续改善。对于球囊扩张失败的类似病例，应考虑进行斑块旋切术。
