Marquis J F, Schwartz L, Brown R, Matushinsky E, Mickleborough L, Aldridge H, Henderson M
Can J Surg. 1985 Jul;28(4):335-7.
Between December 1981 and August 1983, percutaneous transluminal angioplasty of saphenous vein grafts was performed in 14 men and 4 women, selected because of recurrent anginal symptoms and graft stenosis. The interval from bypass to angioplasty was 41 +/- 36 months. Of 24 lesions, 9 were at the proximal anastomosis, 13 in the distal segment and 2 in the middle segment of the vein graft. The primary success rate was 79%. Failure to cross the stenosis occurred in three patients and failure to dilate in one. The stenosis was reduced from a mean of 82% +/- 13% to 26% +/- 15%. No patient required emergency coronary artery bypass grafting but two underwent elective grafting after the angioplasty had failed. No patient sustained a Q-wave myocardial infarction and all who had a successful angioplasty were asymptomatic or much improved after the procedure. Angiographic follow-up was available in 12 of 14 patients (86%). Six patients had significant symptoms (Canadian Cardiovascular Society class II to III) and five of these had evidence of restenosis. Among the six patients who were asymptomatic, two had angiographic evidence of restenosis. The overall rate of restenosis was 58% (7 of 12). Repeat angioplasty was successful in three of the five patients in whom it was attempted. The authors conclude that percutaneous transluminal angioplasty of a saphenous vein graft for a localized area of stenosis is effective and safe, but there is a high rate of restenosis that possibly is due to intimal fibrous proliferation in saphenous vein grafts.
1981年12月至1983年8月期间，对14名男性和4名女性进行了大隐静脉移植血管的经皮腔内血管成形术，这些患者因复发性心绞痛症状和移植血管狭窄而被选中。从旁路手术到血管成形术的间隔时间为41±36个月。在24处病变中，9处位于近端吻合口，13处在移植血管的远端节段，2处在中间节段。初次成功率为79%。3例患者未能穿过狭窄部位，1例未能成功扩张。狭窄程度从平均82%±13%降至26%±15%。没有患者需要急诊冠状动脉旁路移植术，但有2例在血管成形术失败后接受了择期移植术。没有患者发生Q波心肌梗死，所有血管成形术成功的患者术后无症状或病情明显改善。14例患者中有12例（86%）接受了血管造影随访。6例患者有明显症状（加拿大心血管学会II至III级），其中5例有再狭窄证据。在6例无症状患者中，2例有血管造影再狭窄证据。再狭窄总发生率为58%（12例中的7例）。在尝试再次血管成形术的5例患者中，3例成功。作者得出结论，对局限性狭窄区域的大隐静脉移植血管进行经皮腔内血管成形术是有效且安全的，但再狭窄发生率很高，这可能是由于大隐静脉移植血管内膜纤维增生所致。
