Block P C
Circulation. 1985 Dec;72(6 Pt 2):V161-5.
Percutaneous transluminal coronary angioplasty (PTCA) is indicated for many patients with symptomatic coronary atherosclerosis. It can be safely used in patients with unstable angina pectoris, multivessel coronary disease (in selected instances), multiple stenoses in single vessels, stenoses in coronary artery bypass grafts, and recent total coronary occlusion. PTCA may be useful in reestablishing coronary flow after acute myocardial infarction with coronary occlusion and in association with thrombolytic therapy for acute myocardial infarction. The primary success rate of PTCA in experienced hands should be approximately 90%. If restenosis occurs after successful PTCA, a second procedure can be used to dilate the segment with restenosis and the success rate is high. Acute coronary events are the major complications of PTCA. Less than 5% of patients need emergency coronary surgery. Mortality for PTCA is less than 1%. Complications of PTCA diminish with increasing operator experience. PTCA is not indicated for patients with long-standing complete coronary occlusions, diffuse atherosclerotic coronary stenoses without discrete stenotic segments, multiple sites of total occlusions, or "skip" areas in vessels served by bridging collaterals. Patients with main left coronary stenoses and stenoses involving both sides of large-vessel bifurcations are not considered for PTCA in most centers. The choice for or against PTCA should be made after careful assessment of the risk/benefit ratio of PTCA vs coronary bypass surgery.
经皮腔内冠状动脉成形术（PTCA）适用于许多有症状的冠状动脉粥样硬化患者。它可安全用于不稳定型心绞痛、多支冠状动脉疾病（在某些特定情况下）、单支血管多处狭窄、冠状动脉旁路移植血管狭窄以及近期完全冠状动脉闭塞的患者。PTCA对于急性心肌梗死伴冠状动脉闭塞后重建冠状动脉血流以及与急性心肌梗死的溶栓治疗联合使用可能有用。在经验丰富的医生手中，PTCA的主要成功率应约为90%。如果PTCA成功后发生再狭窄，可采用第二次手术扩张再狭窄节段，成功率较高。急性冠状动脉事件是PTCA的主要并发症。不到5%的患者需要急诊冠状动脉手术。PTCA的死亡率低于1%。PTCA的并发症随着术者经验的增加而减少。PTCA不适用于长期完全冠状动脉闭塞、无离散狭窄节段的弥漫性冠状动脉粥样硬化狭窄、多处完全闭塞或有桥接侧支供血血管“跳跃”区域的患者。大多数中心不考虑对左主干冠状动脉狭窄以及累及大血管分叉两侧狭窄的患者进行PTCA。PTCA与否的选择应在仔细评估PTCA与冠状动脉旁路移植手术的风险/获益比之后做出。
