Mabin T A, Holmes D R, Smith H C, Vlietstra R E, Bove A A, Reeder G S, Chesebro J H, Bresnahan J F, Orszulak T A
J Am Coll Cardiol. 1985 Feb;5(2 Pt 1):198-202. doi: 10.1016/s0735-1097(85)80037-1.
Angiograms from 238 consecutive patients who underwent percutaneous transluminal coronary angioplasty at the Mayo Clinic were reviewed to determine the presence of intracoronary thrombus before dilation. Patients with previously occluded vessels and those receiving streptokinase therapy were excluded. Intracoronary thrombus before dilation was present in 15 patients (6%); complete occlusion occurred in 11 (73%) of these during or immediately after dilation. None of these patients had angiographic evidence of major intimal dissection. In contrast, among the 223 patients in whom no intracoronary thrombus was present before dilation, complete occlusion occurred in 18 (8%) and in 12 was associated with major intimal dissection. The difference between the complete occlusion rates for patients with and without prior intracoronary thrombus was highly significant (73 versus 8%, respectively, p less than 0.001). Therefore, the presence of intracoronary thrombus identifies a group of patients who are at increased risk of developing complete occlusion during or after attempted coronary artery dilation.
回顾了梅奥诊所连续238例行经皮腔内冠状动脉成形术患者的血管造影照片，以确定扩张前冠状动脉内血栓的存在情况。排除既往血管闭塞的患者和接受链激酶治疗的患者。15例（6%）患者在扩张前存在冠状动脉内血栓；其中11例（73%）在扩张期间或扩张后立即发生完全闭塞。这些患者均无严重内膜撕裂的血管造影证据。相比之下，在扩张前无冠状动脉内血栓的223例患者中，18例（8%）发生完全闭塞，其中12例与严重内膜撕裂有关。有和无冠状动脉内血栓患者的完全闭塞率差异非常显著（分别为73%和8%，p<0.001）。因此，冠状动脉内血栓的存在表明一组患者在尝试冠状动脉扩张期间或之后发生完全闭塞的风险增加。
