Quiret J C, Remond A, Jarry G, Avinée P, Cazé F
Service de réanimation cardiaque, CHRU, Hôpital Sud, Amiens.
Arch Mal Coeur Vaiss. 1990 Mar;83(3):385-91.
Restenosis is the usual mechanism of recurrent myocardial ischaemia in the months following successful percutaneous transluminal coronary angioplasty (PTCA). Control coronary arteriography may occasionally show another cause: the constitution of a new stenosis near the dilated segment or in the left main coronary stem after angioplasty in a branch of this artery. The authors report 4 cases of patients who developed new coronary stenoses within a few weeks of PTCA, interpreted as traumatic complications of the initial procedure due to a lesion of the intima with a secondary fibrotic reaction and luminal narrowing. The guiding catheter was probably responsible for the trauma to the left main coronary stem whereas the tips of either the balloon catheter or the guide wire were thought to have been responsible for the endothelial effraction of the dilated vessels.
再狭窄是成功进行经皮腔内冠状动脉成形术（PTCA）后数月复发性心肌缺血的常见机制。对照冠状动脉造影偶尔可能显示出另一种原因：在血管成形术的动脉分支扩张段附近或左主干冠状动脉内形成新的狭窄。作者报告了4例患者，他们在PTCA后几周内出现了新的冠状动脉狭窄，这被解释为初始手术的创伤性并发症，是由于内膜损伤继发纤维化反应和管腔狭窄所致。引导导管可能是造成左主干冠状动脉创伤的原因，而球囊导管或导丝的尖端被认为是扩张血管内皮剥脱的原因。
