Deligonul U, Vandormael M G, Kern M J, Zelman R, Galan K, Chaitman B R
Department of Medicine, St. Louis University School of Medicine, Missouri.
J Am Coll Cardiol. 1988 Jun;11(6):1173-9. doi: 10.1016/0735-1097(88)90278-1.
Coronary angioplasty is a widely applied revascularization procedure for patients with multivessel coronary artery disease. However, follow-up in this patient subgroup is relatively limited. From 1983 to 1986, coronary angioplasty was performed in 349 and 121 patients with, respectively, two- and three-vessel coronary disease with a primary success rate of 83 and 88%. The in-hospital mortality rate was 2.8% (13 of 470 patients). Complete revascularization was achieved in 128 patients. Among the 397 patients with a successful outcome, 373 (94%) were followed up greater than or equal to 1 year; 79% were free of death, nonfatal myocardial infarction or the need for coronary bypass grafting, and 82% of patients had symptomatic improvement by at least one angina functional class. A second coronary angioplasty procedure was required in 13% of patients. After a mean follow-up period of 27 months, an increased incidence of coronary bypass grafting was noted in patients with incomplete versus complete revascularization (16 versus 7%, p less than 0.05). Among the 222 patients who had repeat cardiac catheterization performed an average of 7 months after angioplasty, 103 were symptomatic; 50% of the 222 patients had at least one vessel with greater than or equal to 50% restenosis and 14% of patients had multiple restenoses. In conclusion, coronary angioplasty can be performed with a high initial success rate and marked symptomatic improvement in patients with multivessel coronary disease. However, in this group's experience, the majority of patients selected for coronary angioplasty with multivessel coronary disease will have incomplete revascularization that can be predicted in the majority of patients before the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
冠状动脉血管成形术是一种广泛应用于多支冠状动脉疾病患者的血运重建手术。然而，对这一患者亚组的随访相对有限。1983年至1986年期间，分别对349例双支冠状动脉疾病患者和121例三支冠状动脉疾病患者进行了冠状动脉血管成形术，初次成功率分别为83%和88%。住院死亡率为2.8%（470例患者中的13例）。128例患者实现了完全血运重建。在397例手术成功的患者中，373例（94%）接受了至少1年的随访；79%的患者无死亡、非致命性心肌梗死或冠状动脉搭桥术需求，82%的患者心绞痛功能分级至少改善一级。13%的患者需要进行第二次冠状动脉血管成形术。平均随访27个月后，发现不完全血运重建患者的冠状动脉搭桥术发生率高于完全血运重建患者（分别为16%和7%，p<0.05）。在血管成形术后平均7个月接受重复心脏导管检查的222例患者中，103例有症状；222例患者中有50%至少有一支血管再狭窄≥50%，14%的患者有多支血管再狭窄。总之，冠状动脉血管成形术对多支冠状动脉疾病患者可取得较高的初次成功率并显著改善症状。然而，根据该组经验，大多数因多支冠状动脉疾病接受冠状动脉血管成形术的患者会出现不完全血运重建，且在手术前大多数患者可被预测。（摘要截短至250字）
