Myles J L, Ratliff N B, Hollman J, Zaidi A, Tan T B
Department of Pathology, Cleveland Clinic Foundation, Ohio 44106.
Am J Cardiovasc Pathol. 1988;2(2):133-6.
Three patients were studied in whom percutaneous transluminal angioplasty (PTA) was attempted in stenotic saphenous vein bypass grafts. In two cases, large splits were present in the thick fibrotic intima of the vein grafts, accompanied by rupture of atherosclerotic plaques or hemorrhage into atherosclerotic plaques. Both cases required emergency coronary artery bypass surgery. In the third case, a vein graft failed to dilate after multiple attempts. Only small splits were present in that fibrotic intima. Two other patients were studied in whom coronary artery PTA was attempted. In both cases, laceration of a nonatherosclerotic segment of the artery occurred. Combined with our previous report, these observations indicate that PTA results in lacerations of atherosclerotic plaques, fibrotic intima, and otherwise normal vessel walls and that laceration is the mechanism of both successful dilation and serious complications.
对3例患者进行了研究，这些患者的隐静脉搭桥移植血管出现狭窄，尝试进行经皮腔内血管成形术（PTA）。在2例患者中，静脉移植血管增厚的纤维化内膜出现大的撕裂，并伴有动脉粥样硬化斑块破裂或斑块内出血。这2例患者均需要进行急诊冠状动脉搭桥手术。在第3例患者中，经过多次尝试，静脉移植血管未能扩张。该纤维化内膜仅出现小的撕裂。还对另外2例患者进行了研究，尝试对其进行冠状动脉PTA。在这2例患者中，动脉的非动脉粥样硬化节段均发生了撕裂。结合我们之前的报告，这些观察结果表明，PTA会导致动脉粥样硬化斑块、纤维化内膜以及其他正常血管壁的撕裂，并且撕裂是成功扩张和严重并发症的机制。
