Vlietstra R E, Holmes D R, Reeder G S, Mock M B, Smith H C, Bove A A, Bresnahan J F, Piehler J M
Mayo Clin Proc. 1983 Sep;58(9):563-7.
Coronary angioplasty with use of the balloon catheter was initially performed only in patients with single-vessel coronary artery disease. Most symptomatic patients with coronary artery disease who require revascularization for control of their symptoms, however, have stenoses in more than one major coronary artery. Therefore, we have evaluated the results of balloon angioplasty in patients with multivessel disease. Of 261 patients who underwent percutaneous transluminal coronary angioplasty at our institution up to February 1983, 100 had multivessel disease. Of these 100 patients, 72 had an initially successful procedure, defined as successful dilation of one or more major coronary arteries without significant complication. Of the remaining 28 patients, 25 underwent coronary artery bypass grafting (6 on an urgent basis for coronary occlusion). No deaths occurred. In selected patients with multivessel disease, coronary angioplasty is associated with low morbidity and mortality and might be an excellent alternative to coronary artery bypass grafting when medical treatment fails. Percutaneous transluminal coronary angioplasty merits the critical comparison with standard therapy that can be achieved only in a properly designed clinical trial.
最初，使用球囊导管进行冠状动脉血管成形术仅用于单支冠状动脉疾病患者。然而，大多数有症状的冠状动脉疾病患者，需要进行血运重建以控制症状，他们在一支以上的主要冠状动脉存在狭窄。因此，我们评估了多支血管病变患者球囊血管成形术的结果。截至1983年2月，在我们机构接受经皮腔内冠状动脉血管成形术的261例患者中，100例有多支血管病变。在这100例患者中，72例最初手术成功，定义为一支或多支主要冠状动脉成功扩张且无重大并发症。其余28例患者中，25例行冠状动脉旁路移植术（6例因冠状动脉闭塞紧急手术）。无死亡病例。在选定的多支血管病变患者中，冠状动脉血管成形术的发病率和死亡率较低，当药物治疗无效时，可能是冠状动脉旁路移植术的极佳替代方法。经皮腔内冠状动脉血管成形术值得与标准治疗进行关键比较，而这只有在设计合理的临床试验中才能实现。
