Ferguson D W, Kouba C R, Little M M, Osborne J L, White C W, Kioschos J M
J Am Coll Cardiol. 1984 Oct;4(4):820-4. doi: 10.1016/s0735-1097(84)80412-x.
In a 40 year old man with a 1 month total occlusion of a dominant right coronary artery, persistent angina despite medical management indicated inadequate coronary collateral supply to the posterolateral myocardium originally supplied by the totally occluded vessel. Initial attempts at reperfusion of the chronically occluded vessel with an angioplasty guide wire and balloon were unsuccessful. However, administration of intracoronary streptokinase resulted in partial reperfusion, after which successful wire-guided balloon angioplasty was accomplished. This case illustrates the potential utility of combining a thrombolytic agent with angioplasty in attempting reperfusion for management of selected cases of chronic total coronary artery occlusion.
一名40岁男性，其右冠状动脉优势支完全闭塞1个月，尽管接受了药物治疗仍持续心绞痛，这表明原本由完全闭塞血管供血的后外侧心肌的冠状动脉侧支供应不足。最初尝试使用血管成形术导丝和球囊对慢性闭塞血管进行再灌注未成功。然而，冠状动脉内注射链激酶导致部分再灌注，之后成功完成了导丝引导的球囊血管成形术。该病例说明了在尝试对某些慢性冠状动脉完全闭塞病例进行再灌注治疗时，将溶栓剂与血管成形术相结合的潜在效用。
