Tuzcu E M, Simpfendorfer C, Gossman D, Badwhar K
Cleve Clin J Med. 1989 Sep;56(6):577-9. doi: 10.3949/ccjm.56.6.577.
The authors evaluated the long-term outcome of percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery in patients with shepherd's crook morphology (51 patients) compared to a control group (53 patients) matched for lesion location, date of procedure, age, and gender. The primary success rate was lower (86% v 98%; P = .03) in the shepherd's crook group than in the control group. At a mean follow-up of 29 months, there was one death in each group. The restenosis rate was 18% in the shepherd's crook group and 21% in the control group; repeat PTCA (14% v 15%) and bypass surgery (2% v 6%) rates were also similar in both groups. The data suggest that PTCA of right coronary arteries with shepherd's crook morphology has a significantly lower primary success rate but similar long-term outcome when compared to PTCA of right coronary arteries without this anatomic variation.
作者评估了具有牧羊拐形态的患者（51例）右冠状动脉经皮腔内冠状动脉成形术（PTCA）的长期结果，并与在病变位置、手术日期、年龄和性别方面相匹配的对照组（53例）进行了比较。牧羊拐组的主要成功率（86%对98%；P = .03）低于对照组。平均随访29个月时，每组各有1例死亡。牧羊拐组的再狭窄率为18%，对照组为21%；两组的再次PTCA率（14%对15%）和搭桥手术率（2%对6%）也相似。数据表明，与无这种解剖变异的右冠状动脉PTCA相比，具有牧羊拐形态的右冠状动脉PTCA的主要成功率显著较低，但长期结果相似。
