Gambhir D S, Nair M, Prasad R, Sethi K K, Khanna S K, Khalilullah M
Indian Heart J. 1989 Jul-Aug;41(4):233-9.
Out of 55 patients subjected to coronary angioplasty over the past 12 months, there were 33 (60%) who had unstable angina. Amongst these, 22 patients had coronary lesions classified as 'complex' on coronary angiography. These included tandem lesions, branch stenoses, distal lesions, total occlusions, vein graft stenoses, lesions with ulceration and intraluminal clot and associated with valvular lesions. We describe our experience of coronary angioplasty in these 22 patients of unstable angina having 'complex lesions'. All were males with a mean age of 48.7 +/- 13 years. Fourteen patients had single vessel and 8 multivessel disease. A total of 35 lesions were subjected to dilatation. The angiographic primary success was achieved in 85.7% of the lesions attempted. Except total occlusions and very distal lesions, all other types of 'complex lesions' could be dilated with a success rate of greater than 75%. There were 4 (11.4%) failures because of inability to cross the lesion with the guidewire or balloon catheter. One patient developed non-Q wave inferior wall infarction. There were no deaths. We conclude that coronary angioplasty of various types of 'complex lesions' can be performed with a good primary success and negligible complications in our setting.
在过去12个月接受冠状动脉成形术的55例患者中，有33例（60%）患有不稳定型心绞痛。其中，22例患者在冠状动脉造影中冠状动脉病变被分类为“复杂”。这些包括串联病变、分支狭窄、远端病变、完全闭塞、静脉桥狭窄、伴有溃疡和腔内血栓的病变以及与瓣膜病变相关的病变。我们描述了对这22例患有“复杂病变”的不稳定型心绞痛患者进行冠状动脉成形术的经验。所有患者均为男性，平均年龄48.7±13岁。14例患者为单支血管病变，8例为多支血管病变。总共对35处病变进行了扩张。85.7%的尝试扩张的病变在血管造影上获得了初步成功。除了完全闭塞和非常远端的病变外，所有其他类型的“复杂病变”都能以大于75%的成功率进行扩张。有4例（11.4%）失败，原因是导丝或球囊导管无法穿过病变。1例患者发生非Q波下壁梗死。无死亡病例。我们得出结论，在我们的治疗环境中，对各种类型的“复杂病变”进行冠状动脉成形术可以获得良好的初步成功率且并发症极少。
