McKenna C J, McCann H A, Sugrue D D
Department of Clinical Cardiology, Mater Misericordiae Hospital (University College), Dublin.
Ir Med J. 1995 Jan-Feb;88(1):32.
The problems of restenosis and abrupt occlusion following percutaneous transluminal coronary angioplasty (PTCA) remain a challenge. Restenosis occurs in 30-50% of lesions treated and substantially erodes the potential advantage of percutaneous treatment of obstructive coronary disease over alternative revascularisation strategies. Abrupt closure occurs in 5-7% of cases with significant associated morbidity and mortality. Up to 35% of patients require emergency bypass surgery for treatment of abrupt closure and more than half sustain a perioperative myocardial infarction. By debulking atherosclerotic lesions, atherectomy offers the potential to reduce restenosis. Coronary stenting, by acting as a scaffolding can sometimes solve the problem of abrupt closure due to intimal dissection. We report the use of emergency placement of multiple coronary stents for obstructive coronary dissection complicating rotational atherectomy.
经皮腔内冠状动脉成形术（PTCA）后再狭窄和急性闭塞问题仍然是一项挑战。在接受治疗的病变中，30%至50%会发生再狭窄，这大大削弱了经皮治疗阻塞性冠状动脉疾病相对于其他血管重建策略的潜在优势。5%至7%的病例会发生急性闭塞，伴有显著的发病率和死亡率。高达35%的患者需要急诊搭桥手术来治疗急性闭塞，超过一半的患者会发生围手术期心肌梗死。斑块旋切术通过消除动脉粥样硬化病变，具有降低再狭窄的潜力。冠状动脉支架作为一种支架，有时可以解决因内膜撕裂导致的急性闭塞问题。我们报告了紧急置入多个冠状动脉支架治疗旋切术后并发的阻塞性冠状动脉夹层的应用情况。
