Vallbracht C, Hermansson S, Kober G, Kaltenbach M
Zentrum der Inneren Medizin, Universitätsklinikum Frankfurt.
Z Kardiol. 1987 Nov;76(11):713-7.
Functional and angiographic follow-up was performed in 61 patients 3.9 months (range 2-8 months) and 3.7 years (range 2-8 years) after successful transluminal coronary angioplasty. The mean degree of stenosis prior to angioplasty was 78.7% and after the procedure, 36%. After 3.9 months there was a slight increase to 39% because of 12 recurrences. In three of these patients a second angioplasty was performed; nine were continued on medical treatment because of sustained clinical benefit. After 3.7 years, the mean degree of stenosis was 29%. No patient with persistent vessel patency after 3.9 months showed an increase of the dilated stenosis of more than 15% after 3.7 years. Prior to angioplasty, 41 patients (75%) had one-vessel disease; 19 (18%) two- and 4 (7%) three-vessel disease. 2-8 years after successful angioplasty, 48% of patients showed no stenosis of greater than or equal to 50% narrowing. Progression of coronary artery disease was found in 29/61 patients at the late follow-up. Of these 29 patients, 11 underwent another angioplasty because of a new stenosis in another vessel or segment; 18 were treated medically. There was no need for bypass surgery. It is concluded that a sustained success 3.9 months after angioplasty predicts excellent long-term vessel patency.
在61例患者成功进行经皮腔内冠状动脉成形术后3.9个月（范围2 - 8个月）和3.7年（范围2 - 8年）进行了功能和血管造影随访。血管成形术前狭窄的平均程度为78.7%，术后为36%。3.9个月后，由于12例复发，狭窄程度略有增加至39%。其中3例患者进行了第二次血管成形术；9例因持续的临床获益继续接受药物治疗。3.7年后，狭窄的平均程度为29%。3.9个月后血管持续通畅的患者中，没有患者在3.7年后扩张后的狭窄增加超过15%。血管成形术前，41例患者（75%）为单支血管病变；19例（18%）为两支血管病变，4例（7%）为三支血管病变。成功血管成形术后2 - 8年，48%的患者狭窄程度未超过或等于50%。在晚期随访中，61例患者中有29例发现冠状动脉疾病进展。在这29例患者中，11例因另一支血管或节段出现新的狭窄而接受了另一次血管成形术；18例接受了药物治疗。无需进行搭桥手术。结论是血管成形术后3.9个月的持续成功预示着长期血管通畅良好。
