Sowton E, Timmis A D, Crick J C, Griffin B, Yates A K, Deverall P
Br Heart J. 1986 Aug;56(2):115-20. doi: 10.1136/hrt.56.2.115.
In a consecutive series of 400 patients treated by percutaneous transluminal coronary angioplasty 212 had single vessel disease, 142 had multivessel disease with only one vessel dilated, and 46 had multivessel dilatation. In addition sequential stenoses were dilated in the same vessel in all groups. There was no mortality among patients with single vessel disease. Success rates varied from 83% to 90% according to the artery in which angioplasty was attempted. Urgent surgery was required by 3.8%. Primary success was lower (74%) in the presence of multivessel disease and complications were more frequent, with four deaths (2.8%). In 46 patients with multivessel disease in whom all important lesions were dilated during the same procedure the overall primary success rate was 76% and within the last year of the study it was 91%. One (2%) patient died and three (7%) required urgent surgery. Twelve (86%) out of 14 stenosed vein grafts were successfully dilated and eight (53%) chronically occluded vessels were re-opened; in both groups there were no deaths, no infarctions, and no need for urgent surgery. In all groups symptoms improved greatly and predischarge exercise tests showed that there was no reversible ischaemia in 94% of patients with single vessel disease or in 65% of patients with incomplete revascularisation. Six months after the procedure 95% of the patients had improved symptomatically and 80% had normal exercise tests after one year. Percutaneous transluminal coronary angioplasty is the method of choice in single vessel disease and its use also results in a high proportion of other patients becoming symptom free. Complication rates are low and for selected patients results that are equivalent to those of cardiac surgery are obtained.
在连续接受经皮腔内冠状动脉成形术治疗的400例患者中，212例为单支血管病变，142例为多支血管病变且仅扩张了1支血管，46例进行了多支血管扩张。此外，所有组中同一血管的序贯狭窄均进行了扩张。单支血管病变患者中无死亡病例。根据尝试进行血管成形术的动脉不同，成功率在83%至90%之间。3.8%的患者需要紧急手术。多支血管病变时的初始成功率较低（74%），并发症更常见，有4例死亡（2.8%）。在46例多支血管病变且在同一手术过程中所有重要病变均得到扩张的患者中，总体初始成功率为76%，在研究的最后一年该成功率为91%。1例（2%）患者死亡，3例（7%）需要紧急手术。14处狭窄的静脉移植物中有12处（86%）成功扩张，8处慢性闭塞血管中有8处（53%）重新开通；两组均无死亡、无梗死，也无需紧急手术。所有组患者症状均有明显改善，出院前运动试验显示，单支血管病变患者中有94%、血管再通不完全的患者中有65%无可逆性缺血。术后6个月，95%的患者症状有所改善，1年后80%的患者运动试验正常。经皮腔内冠状动脉成形术是单支血管病变的首选治疗方法，对其他患者使用该方法也可使很大一部分患者症状消失。并发症发生率低，对于特定患者可获得与心脏手术相当的效果。
