Onodera T, Fujiwara H, Tanaka M, Wu D J, Matsuda M, Takemura G, Ishida M, Kawamura A, Kawai C
Department of Internal Medicine, Kyoto University, Japan.
Br Heart J. 1989 May;61(5):385-9. doi: 10.1136/hrt.61.5.385.
The postmortem histology and the results of cineangiography after selective intracoronary thrombolysis in vessels that were recanalized and in those that were not were compared in 21 patients who died within seven days (mean 2 days) of selective intracoronary thrombolysis. There was a persistent intraluminal thrombus in the infarct related coronary artery in five of six segments in which recanalisation was unsuccessful and in one of 15 segments in which recanalisation was successful. Rupture and haemorrhage of the atheromatous plaque were seen in most of the infarct related segments, both in those in which recanalisation was achieved and in those in which it was not. Irregular narrowing and filling defects on the coronary cineangiograms were associated with rupture and haemorrhage of the atheromatous plaque. These results suggest that failure of coronary thrombolysis to recanalize the infarct related artery does not indicate that the occlusion was not caused by thrombus.
对21例在选择性冠状动脉内溶栓术后7天内（平均2天）死亡的患者，比较了再通血管和未再通血管在尸检组织学及选择性冠状动脉内溶栓术后血管造影的结果。在再通未成功的6个节段中的5个以及再通成功的15个节段中的1个节段，梗死相关冠状动脉内存在持续的腔内血栓。在大多数梗死相关节段均可见动脉粥样硬化斑块破裂和出血，无论再通与否。冠状动脉血管造影上的不规则狭窄和充盈缺损与动脉粥样硬化斑块破裂和出血相关。这些结果表明，冠状动脉溶栓未能使梗死相关动脉再通并不意味着阻塞不是由血栓引起的。
