Sharma B, Wyeth R P, Kolath G S, Gimenez H J, Franciosa J A
Cardiovascular Division, University of Arkansas for Medical Sciences, Little Rock 72205.
Br Heart J. 1988 Mar;59(3):280-6. doi: 10.1136/hrt.59.3.280.
Forty patients with unstable angina refractory to medical treatment had one vessel percutaneous transluminal angioplasty to the most stenotic lesion in a major coronary artery. The procedure was successful in 35 patients, and the remaining five patients underwent emergency coronary artery bypass graft surgery. The initial success rate (84%) for the 16 patients with single or the 19 patients with multivessel disease (90%) was similar. At early follow up (average nine days) all patients with successful angioplasty remained symptomatically improved; 10 patients (83%) with single and 10 patients (63%) with multivessel disease had negative treadmill stress tests. Five of six cardiac events occurred within the intermediate (average 11 months) follow up period; two patients had recurrent refractory unstable angina, two had angioplasty for progression of disease in a vessel not previously treated by angioplasty, and one had bypass graft surgery. During late (average 26 months) follow up one patient had a non-fatal myocardial infarction while seven patients (58%) with single vessel disease and nine patients (75%) with multivessel disease had negative stress tests; 29 of 40 patients showed long term improvement.
40例药物治疗无效的不稳定型心绞痛患者对其主要冠状动脉中最狭窄的病变进行了单支血管经皮腔内血管成形术。该手术在35例患者中成功，其余5例患者接受了急诊冠状动脉旁路移植术。单支血管病变的16例患者和多支血管病变的19例患者的初始成功率（分别为84%和90%）相似。在早期随访（平均9天）时，所有血管成形术成功的患者症状均有改善；单支血管病变的10例患者（83%）和多支血管病变的10例患者（63%）运动平板试验结果为阴性。6例心脏事件中有5例发生在中期（平均11个月）随访期内；2例患者出现复发性难治性不稳定型心绞痛，2例患者因未接受过血管成形术治疗的血管病变进展而接受血管成形术，1例患者接受了旁路移植术。在晚期（平均26个月）随访期间，1例患者发生非致命性心肌梗死，而单支血管病变的7例患者（58%）和多支血管病变的9例患者（75%）运动平板试验结果为阴性；40例患者中有29例显示出长期改善。
