Ilia R, Bigham H, Brennan J, Cabin H, Cleman M, Remetz M
Section of Cardiovascular Medicine, Yale University, School of Medicine, New Haven, Conn.
Cardiology. 1994;85(3-4):229-34. doi: 10.1159/000176680.
To determine predictors of acute coronary dissection after coronary angioplasty, we studied 170 consecutive patients who underwent arterial dilatations of 234 arteries. Coronary dissection occurred in 103 (44%) arteries. More dissections occurred in women [40/73 (55%) versus 63/161 (39%), p < 0.03] and in patients with long lesions [45/74 (61%) versus 56/158 (35%), p < 0.0005]. Balloon/arterial diameter ratio was higher in patients with dissection (1.1 +/- 0.2 versus 1.0 +/- 0.2, p < 0.02). Complications did not differ in patients with and without dissection except for non-Q wave myocardial infarctions which were more frequent in patients with coronary dissection [10/12 (83%) versus 2/12 (17%), p < 0.01]. Thus coronary dissection during angioplasty is relatively frequent. However, most dissections are not associated with complications. Balloon dilatation of lesions in female patients and in patients with long lesions are more likely to result in dissection.
为了确定冠状动脉血管成形术后急性冠状动脉夹层的预测因素，我们研究了170例连续接受234条动脉扩张术的患者。103条（44%）动脉发生了冠状动脉夹层。女性发生夹层的情况更多[40/73（55%）对63/161（39%），p<0.03]，长病变患者也是如此[45/74（61%）对56/158（35%），p<0.0005]。夹层患者的球囊/动脉直径比更高（1.1±0.2对1.0±0.2，p<0.02）。有夹层和无夹层患者的并发症情况无差异，但非Q波心肌梗死在冠状动脉夹层患者中更常见[10/12（83%）对2/12（17%），p<0.01]。因此，血管成形术中冠状动脉夹层相对常见。然而，大多数夹层与并发症无关。女性患者和长病变患者的病变球囊扩张更易导致夹层。
