Ford W B, Wholey M H, Zikria E A, Miller W H, Samadani S R, Koimattur A G, Sullivan M E
J Thorac Cardiovasc Surg. 1980 Jan;79(1):1-11.
Since January, 1978, we have evaluated 18 patients in whom segmental occlusive disease of the aorta-coronary saphenous vein graft or the native coronary circulation was present. The significantly occluded vessels were restored to relatively normal circulation by means of percutaneous transluminal dilatation in 10 of these patients, with technical failures in seven patients and the occurrence of a thrombosis during the procedure in one other. Successful dilatation occurred in six of the seven patients with saphenous vein graft stenosis. Percutaneous transluminal angioplasty of the native coronary arteries in 11 patients resulted in five successful dilatations. All dilatation procedures are performed with the use of local anesthesia with an open-heart team standing by. In the event of technical failure or incipient thrombosis with developing infarction, the patient is transferred for immediate bypass. On the basis of these early results, we have developed guidelines of the indications for percutaneous transluminal dilatation of the coronary arteries and their saphenous vein grafts. The need for improved instrumentation to broaden these guidelines is discussed. Case histories of five patients are presented, and a summary table for all 18 patients is also provided. Certain inherent complications are discussed, but our preliminary results are encouraging, particularly with regard to stenoses of saphenous vein bypass grafts.
自1978年1月以来，我们对18例患者进行了评估，这些患者存在主动脉 - 冠状动脉静脉搭桥血管或自身冠状动脉循环的节段性闭塞性疾病。在这些患者中，采用经皮腔内血管成形术使10名患者的严重闭塞血管恢复到相对正常的循环状态，7名患者手术失败，另有1名患者在手术期间发生血栓形成。在7名患有大隐静脉移植血管狭窄的患者中，6名患者扩张成功。11例患者接受自身冠状动脉经皮腔内血管成形术，其中5例扩张成功。所有扩张手术均在局部麻醉下进行，心脏直视手术团队随时待命。如果出现技术失败或早期血栓形成并伴有梗死发展，患者将被立即转至旁路手术。基于这些早期结果，我们制定了冠状动脉及其大隐静脉移植血管经皮腔内扩张术的适应证指南。文中讨论了改进器械以拓宽这些指南的必要性。文中给出了5例患者的病例史，并提供了所有18例患者的汇总表。文中讨论了某些固有的并发症，但我们的初步结果令人鼓舞，特别是对于大隐静脉旁路移植血管狭窄的情况。
