Tong Y, Somjen G, Teeuwsen W, Royle J P
Vascular Surgery Unit, Austin Hospital, Melbourne, Australia.
Cardiovasc Surg. 1994 Aug;2(4):503-7.
Between 1986 and 1992, 308 percutaneous transluminal angioplasties in 252 patients were reviewed in the vascular laboratory of the Austin Hospital. The follow-up period ranged from 1 month to 6 years. Treadmill exercise testing was used as an additional mode of assessment to resting ankle/brachial pressure indices in monitoring outcome. Early haemodynamic improvement rate was 86.7%. In 267 successful cases, 199 had increased the mean(s.d.) resting ankle/brachial pressure index from 0.68(0.15) to 0.96(0.14) (P < 0.05) and another 68 with normal or unchanged resting ankle/brachial pressure indices after the procedure increased the mean(s.d.) post-exercise pressure index from 0.45(0.24) to 0.82(0.23) (P < 0.05). The primary haemodynamic improvement rate of initially successful percutaneous transluminal angioplasties was 80.1% at 1 year and was maintained in 46.1% of cases 5 years after. Treadmill exercise testing revealed reduction of the ankle/brachial pressure index in 69 patients during follow-up, indicating restenosis of the dilated lesion or development of a new arterial stenosis. Fifty-two of the 69 patients exhibited a significant drop in the resting pressure index. However, in the 17 remaining patients, only the post-exercise index decrease indicated haemodynamic deterioration. Treadmill exercise testing proved to be valuable adjunct in detecting haemodynamic changes after percutaneous transluminal angioplasty.
1986年至1992年间，奥斯汀医院血管实验室对252例患者的308次经皮腔内血管成形术进行了回顾性研究。随访时间为1个月至6年。在监测结果时，跑步机运动试验被用作评估静息踝/臂压力指数的额外方法。早期血液动力学改善率为86.7%。在267例成功病例中，199例患者的静息踝/臂压力指数均值（标准差）从0.68（0.15）升至0.96（0.14）（P<0.05），另外68例术后静息踝/臂压力指数正常或未改变的患者，运动后压力指数均值（标准差）从0.45（0.24）升至0.82（0.23）（P<0.05）。最初成功的经皮腔内血管成形术的主要血液动力学改善率在1年时为80.1%，5年后仍有46.1%的病例保持该改善率。跑步机运动试验显示，69例患者在随访期间踝/臂压力指数降低，提示扩张病变处再狭窄或出现新的动脉狭窄。69例患者中有52例静息压力指数显著下降。然而，在其余17例患者中，只有运动后指数下降表明血液动力学恶化。跑步机运动试验被证明是检测经皮腔内血管成形术后血液动力学变化的有价值辅助手段。
