Finci L, Divernois J, Meier B, Divernois S, Ratib O, Righetti A, Rutishauser W
Schweiz Med Wochenschr. 1985 Nov 9;115(45):1587-90.
Between August 1983 and October 1984, 44 patients (39 male and 5 female, mean age 53 years) underwent multivessel percutaneous transluminal coronary angioplasty involving 2 vessels in 37 (84%), 3 vessels in 4 (9%), 4 vessels in 1 (2%) and coronary artery bypass graft plus 1 or 2 vessels in 2 (5%). A mean of 2.2 vessels per patient were attempted. Dilatations of multiple stenoses in the same vessel were not included. Primary success was achieved in 87 of 97 vessels (90%) and in 37 of 44 (84%) patients. Primary success per patient was defined as primary success in all or at least in the strategic lesions associated with clinical improvement of the patient. Complications included one death (2%), emergency coronary artery bypass surgery in one (2%) and myocardial infarction in 2 (4%) patients. Five other patients underwent elective coronary artery bypass surgery. Recurrence of lesion was 14% (5/37 patients) during a follow-up period of 3 to 12 months. Repeat angioplasty was successful in 4 patients (80%) and unsuccessful in 1 patient who underwent elective surgery. It is concluded that, in selected cases, multivessel percutaneous transluminal coronary angioplasty is a feasible alternative to coronary artery bypass surgery, with comparable risks. A satisfactory long-term amelioration without coronary artery surgery can be obtained in 2/3 of patients.
1983年8月至1984年10月期间，44例患者（39例男性，5例女性，平均年龄53岁）接受了多支血管经皮腔内冠状动脉成形术，其中37例（84%）累及2支血管，4例（9%）累及3支血管，1例（2%）累及4支血管，2例（5%）为冠状动脉搭桥术加1或2支血管成形术。每位患者平均尝试扩张2.2支血管。同一血管内多个狭窄的扩张不包括在内。97支血管中的87支（90%）和44例患者中的37例（84%）获得了初次成功。每位患者的初次成功定义为在所有或至少与患者临床改善相关的关键病变中取得初次成功。并发症包括1例死亡（2%）、1例急诊冠状动脉搭桥手术（2%）和2例心肌梗死（4%）。另外5例患者接受了择期冠状动脉搭桥手术。在3至12个月的随访期内，病变复发率为14%（5/37例患者）。4例患者（80%）再次血管成形术成功，1例接受择期手术的患者失败。结论是，在特定病例中，多支血管经皮腔内冠状动脉成形术是冠状动脉搭桥手术的一种可行替代方法，风险相当。三分之二的患者无需冠状动脉手术即可获得满意的长期改善。
