Dorros G, Stertzer S H, Cowley M J, Myler R K
Am J Cardiol. 1984 Jun 15;53(12):126C-130C. doi: 10.1016/0002-9149(84)90765-3.
Selected patients underwent PTCA of multiple stenoses in different vessels or in the same vessel. Three hundred nine patients underwent 685 PTCA procedures in various combinations of arterial and vein graft stenoses. A multiple dilatation procedure was defined as successful when all lesions attempted were successfully dilated, or when the considered-critical-stenosis was successfully dilated and this resulted in a patient clinical improvement. Angiographic success was achieved in 599 of 685 lesions attempted (87.4%) and in 285 of 309 patients (92.2%). Complications included a mortality rate of 1.0%, an MI rate of 4.2% per patient and 1.9% per lesion attempted, and a 3.6% incidence of emergency CABG. Follow-up data show that 58 patients (20.4%) had clinical evidence of a lesion recurrence, and that 92.5% (37 of 40 patients) who underwent repeat angioplasty had a successful procedure. A sustained clinical improvement was obtained in 264 of 309 patients (85.4%). The data indicate that multiple dilatations are feasible with good success rates and acceptable complication rates. Further evaluation of this extended application of PTCA is needed to clearly establish its role in the therapy of CAD.
部分患者接受了不同血管或同一血管内多处狭窄的经皮腔内冠状动脉成形术（PTCA）。309例患者接受了685次PTCA手术，涉及动脉和静脉移植血管狭窄的各种组合。当所有尝试的病变均成功扩张，或当被视为关键狭窄的病变成功扩张并导致患者临床症状改善时，多次扩张手术被定义为成功。在685次尝试的病变中，599次（87.4%）实现了血管造影成功；在309例患者中，285例（92.2%）实现了血管造影成功。并发症包括1.0%的死亡率、每位患者4.2%且每次尝试病变1.9%的心肌梗死发生率以及3.6%的急诊冠状动脉旁路移植术（CABG）发生率。随访数据显示，58例患者（20.4%）有病变复发的临床证据，并且接受再次血管成形术的患者中有92.5%（40例中的37例）手术成功。309例患者中有264例（85.4%）获得了持续的临床改善。数据表明，多次扩张是可行的，成功率良好且并发症发生率可接受。需要对PTCA的这种扩展应用进行进一步评估，以明确其在冠心病治疗中的作用。
