Schwartz L, Brooks E, Henderson M, Brown R, Aldridge H, Kendall S, Cseplo R M, Szarga C
Can J Cardiol. 1987 Jan-Feb;3(1):6-9.
This study consisted of a one year clinical follow-up of 81 patients who had coronary revascularization. In 32 patients, this was accomplished by bypass surgery and in 49, by percutaneous angioplasty. Prior to the procedure the two groups of patients were similar with regard to age, sex, antianginal medication and angina severity with 75% of the surgical patients and 65% of the angioplasty patients in CCS Angina Class III or IV. Although most of the surgical patients had multivessel disease and most of the angioplasty patients had single vessel disease, all had complete revascularization. At one year, 78% of the surgical patients and 84% of the angioplasty patients did not have angina and few patients in either group were taking medication. However, in the intervening year 39% of the angioplasty patients had had a second revascularization procedure, whereas, only 3% of the surgical patients required a second procedure. Extracardiac sequelae were more frequent in the surgical cohort. Therefore, at one year following complete revascularization, bypass surgery and angioplasty result in comparable symptomatic and functional improvement.
本研究对81例行冠状动脉血运重建术的患者进行了为期一年的临床随访。其中32例患者通过搭桥手术实现血运重建,49例通过经皮血管成形术实现。术前,两组患者在年龄、性别、抗心绞痛药物使用情况及心绞痛严重程度方面相似,接受手术的患者中有75%、接受血管成形术的患者中有65%属于加拿大心血管学会(CCS)心绞痛分级III级或IV级。尽管大多数接受手术的患者患有多支血管病变,大多数接受血管成形术的患者患有单支血管病变,但所有患者均实现了完全血运重建。一年时,78%的手术患者和84%的血管成形术患者无心绞痛症状,两组中服用药物的患者均较少。然而,在这一年期间,39%的血管成形术患者接受了二次血运重建手术,而只有3%的手术患者需要进行二次手术。心脏外后遗症在手术组中更为常见。因此,在完全血运重建术后一年,搭桥手术和血管成形术在症状和功能改善方面效果相当。