Kishi K, Hiasa Y, Kinoshita M, Kondo N, Fujinaga H, Ohtani R, Wada T, Aihara T
Department of Cardiology, Komatsushima Red Cross Hospital, Tokushima.
J Cardiol. 1995 Jun;25(6):303-8.
The acute and long-term outcomes of percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery (RCA) or left circumflex branch (LCS) in patients with chronic occlusion of the left anterior descending branch (LAD) (group A) were compared with those of sex and age matched patients undergoing PTCA of the RCA or LCX with a normal LAD (group B). Before the procedure, group A had more frequent prior myocardial infarction (96% vs 33%, p < 0.001), and a lower left ventricular ejection fraction (LVEF) (49 +/- 14% vs 71 +/- 13%, p < 0.001). The acute results were similar in the two groups with respect to primary success (group A 90%, group B 91%) and major complications (group A 6%, group B 2%). At 3 months, the rate of restenosis was 33% in group A and 27% in group B. In group A, LVEF increased significantly in patients without restenosis (53 +/- 11% vs 62 +/- 11%, p < 0.01). At long-term follow-up, group A had higher rates of persistent angina but there was no difference in outcome between the two groups. In patients with chronic total occlusion of LAD, PTCA for RCA or LCX can be performed with a low complication rate and provides a significant improvement in LVEF at 3 months in the absence of restenosis. However, at short-term follow-up, these patients have a greater incidence of persistent angina.
将左前降支（LAD）慢性闭塞患者（A组）右冠状动脉（RCA）或左旋支（LCS）行经皮腔内冠状动脉成形术（PTCA）的急性和长期结果，与年龄和性别匹配的左前降支正常而行RCA或左旋支（LCX）PTCA的患者（B组）进行比较。术前，A组既往心肌梗死发生率更高（96%对33%，p<0.001），左心室射血分数（LVEF）更低（49±14%对71±13%，p<0.001）。两组的急性结果在主要成功率（A组90%，B组91%）和主要并发症（A组6%，B组2%）方面相似。3个月时，A组再狭窄率为33%，B组为27%。在A组中，无再狭窄的患者LVEF显著增加（53±11%对62±11%，p<0.01）。长期随访时，A组持续性心绞痛发生率更高，但两组结局无差异。对于LAD慢性完全闭塞的患者，RCA或LCX的PTCA可以在低并发症率下进行，并且在3个月时若无再狭窄可使LVEF显著改善。然而，在短期随访中，这些患者持续性心绞痛的发生率更高。
