Pidgeon J, Treasure T, Brooks N, Cattell M, Balcon R
Br Heart J. 1984 Feb;51(2):125-9. doi: 10.1136/hrt.51.2.125.
In 60 consecutive patients undergoing vein graft surgery the angiographic appearances of the coronary vessels were compared with those of the vessels at operation. On the basis of lumen diameter at the potential sites for grafting it was possible to predict with reasonable accuracy from examination of the angiogram which vessels were large enough to be grafted. Angiographic predictive accuracy was 82% and was similar both for vessels which filled normally and for those which filled by collaterals. The predictive value of the angiographic assessment was similar for branches thought to be too small (predictive value 74%) and for those considered sufficiently large (predictive value 85%) to receive a vein graft. Disease of the vessel walls was found at surgery (66% of coronary branches examined) more frequently than was predicted from the angiographic appearances (33%). Previous necropsy studies have found a high prevalence of coronary atheroma in the population, yet normal angiographic appearances in the coronary arteries are not uncommon in patients undergoing investigation for suspected coronary disease. The present study showed that atheroma may be present in coronary vessels without encroaching into the vessel lumen, so that it is not evident on the angiogram. Coronary atheroma is thus present more often and is more widely distributed in the coronary tree than is indicated by coronary angiography.
在60例连续接受静脉移植手术的患者中，将冠状动脉血管的血管造影表现与手术时血管的表现进行了比较。根据潜在移植部位的管腔直径，通过血管造影检查能够以合理的准确性预测哪些血管足够大可以进行移植。血管造影的预测准确率为82%，对于正常充盈的血管和通过侧支循环充盈的血管而言相似。血管造影评估对于被认为太小（预测价值74%）和被认为足够大（预测价值85%）以接受静脉移植的分支的预测价值相似。手术时发现血管壁病变（在所检查的冠状动脉分支中占66%）比血管造影表现所预测的（33%）更频繁。先前的尸检研究发现人群中冠状动脉粥样硬化的患病率很高，但在接受疑似冠心病检查的患者中，冠状动脉血管造影表现正常并不少见。本研究表明，冠状动脉粥样硬化可能存在于冠状动脉血管中而不侵犯血管腔，因此在血管造影上不明显。因此，冠状动脉粥样硬化的存在比冠状动脉造影所显示的更常见，且在冠状动脉树中分布更广泛。
