Kahn J K, Hartzler G O
Cardiovascular Consultants, Inc., Mid America Heart Institute, St. Luke's Hospital, Kansas City, Missouri.
Cathet Cardiovasc Diagn. 1990 Jun;20(2):88-93. doi: 10.1002/ccd.1810200205.
Progression of native coronary artery disease proximal to the placement of saphenous vein grafts may leave arterial segments isolated by stenoses on either side. In 16 patients, we attempted coronary angioplasty in a retrograde direction through saphenous vein grafts to revascularize 17 isolated arterial segments. The retrograde dilatation was successful in 12 of 17 attempts (71%). Failure in 5 attempts was due to severe angulation between the graft insertion site and the retrograde proximal arterial limb. There were no major complications of these procedures. Symptoms and signs of myocardial ischemia were relieved following successful retrograde dilatation. Thus, retrograde dilatation through saphenous vein grafts provides another means of achieving complete revascularization using coronary angioplasty in patients with prior coronary bypass surgery.
在隐静脉移植血管置入部位近端，自身冠状动脉疾病的进展可能会使动脉节段被两侧的狭窄所孤立。在16例患者中，我们尝试通过隐静脉移植血管进行逆行冠状动脉血管成形术，以恢复17个孤立动脉节段的血运重建。17次尝试中有12次（71%）逆行扩张成功。5次尝试失败是由于移植血管插入部位与逆行近端动脉分支之间存在严重成角。这些操作没有出现重大并发症。成功逆行扩张后，心肌缺血的症状和体征得到缓解。因此，对于既往接受过冠状动脉搭桥手术的患者，通过隐静脉移植血管进行逆行扩张为利用冠状动脉血管成形术实现完全血运重建提供了另一种方法。
