Rodríguez A, Santaera O, Risau G, Sosa Liprandi M I, Díaz R, Baliño N P, Lugones M
Departamento de Hemodinamia y Cardiología, Praxis Médica y Sanatorio Anchoreana, Buenos Aires, Argentina.
Medicina (B Aires). 1990;50(6):505-12.
Consecutive prospective coronary angiographies following 24 hours were studied to find early angiographic predictors of post-PTCA restenosis in the follow-up of 71 patients who had been dilated successfully. Conventional cine coronary and quantitative digital angiography was used to analyse the degree of obstruction previous to dilatation following 24 hours and 30 minutes after the procedure. Following 24 hours, angiographic findings showed: Group A: patients having the same lumen as at immediate post-PTCA time (65.9%); Group B: patients with 20% or more immediate post-PTCA time (21.5%). Group C: patients with total obstruction of vessel (12.6%). The basal clinical conditions were similar in the three groups. The degree of basal obstruction and the clinical findings were similar in the three groups; the dilated arteries in Groups A and B were similar and total occlusion before PTCA was more frequent in Group C than in B and A; 30 minutes post PTCA lesions in group A had less residual stenosis than group B (p less than .01) and C (p = NS), this difference increased significantly (p less than .0001) at 24 hours and in the late follow-up. In the follow-up (means 6.4 months) there was total restenosis per lesion in 32.9%. In Group A, there was 8.6%; in Group B, 68.4% (p less than .0001) and in Group B plus C, 80%. Patients with more than 10% obstruction had a greater degree of restenosis (43.9%) than when the initial lesion was less than 10% (23.4%).(ABSTRACT TRUNCATED AT 250 WORDS)
对71例成功进行扩张的患者进行随访,研究术后24小时连续进行的前瞻性冠状动脉造影,以寻找经皮冠状动脉腔内血管成形术(PTCA)后再狭窄的早期血管造影预测指标。采用传统的冠状动脉电影造影和定量数字血管造影分析术后24小时及30分钟扩张前的阻塞程度。术后24小时,血管造影结果显示:A组:术后即刻管腔与PTCA后相同的患者(65.9%);B组:术后即刻管腔狭窄20%或更多的患者(21.5%);C组:血管完全阻塞的患者(12.6%)。三组的基础临床情况相似。三组的基础阻塞程度和临床表现相似;A组和B组扩张的动脉相似,C组PTCA前完全闭塞的情况比B组和A组更常见;A组PTCA术后30分钟的病变残余狭窄比B组(p<0.01)和C组(p=无统计学意义)少,这种差异在24小时及后期随访时显著增加(p<0.0001)。在随访(平均6.4个月)中,每个病变的完全再狭窄率为32.9%。A组为8.6%;B组为68.4%(p<0.0001),B组加C组为80%。初始病变阻塞超过10%的患者再狭窄程度(43.9%)高于初始病变小于10%的患者(23.4%)。(摘要截断于250字)