Baumbach A, Oswald H, Kvasnicka J, Fleck E, Geschwind H J, Ozbek C, Reifart N, Bertrand M E, Karsch K R
Medizinische Klinik III, University of Tübingen, Germany.
Eur Heart J. 1994 Jan;15(1):89-96. doi: 10.1093/oxfordjournals.eurheartj.a060385.
From January 1991 to January 1993 the clinical and angiographic data of 470 patients were included in the European Coronary Excimer Laser Angioplasty Registry. Symptoms were CCS class 3 in 23% and CCS class 4 in 14.7%; unstable angina was present in 14.7% and 6.6% of patients had acute myocardial infarction. Of 477 treated lesions, 60% were type B2, and 19% type C. The lesion was located in the LAD in 61%, in the LCX in 16%, in the RCA in 20%, in a protected left main stem in 1.3% and in a saphenous vein graft in 2.5%, respectively. Failure of laser angioplasty occurred in 56 (12%) interventions. By multivariate analysis failure was associated with the intention to treat long segmental lesions (risk ratio (RR) 3.6, confidence interval (CI) 2.9 to 4.4; P = 0.0005), segments with severe prestenotic tortuosity (RR 3.5, CI 2.4 to 4.6; P = 0.02) and total occlusions (RR 2.1; CI 1.4 to 2.8; P = 0.05). Complications included vasospasm (13.4%), dissection (14.7%), flow limiting dissection (4%), reclosure (7.8%), and perforation (1.9%). Myocardial infarction occurred in 2.1%, CABG was requested in 1.9%, and the mortality was 1.5%. Procedural success was achieved in 89%. Individual morphological criteria for a reduced procedural success were the presence of a thrombus (RR 6.4; CI 5.0 to 7.7; P = 0.007) and vessel calcification (RR 2.6; CI 1.9 to 3.2; P = 0.005). Procedural success was slightly lower in type C lesions (86%) than in type B2 (88%) type B1 (95%), and type A lesions (92%), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
1991年1月至1993年1月期间，470例患者的临床和血管造影数据被纳入欧洲冠状动脉准分子激光血管成形术注册研究。症状方面，加拿大心血管学会（CCS）分级为3级的患者占23%，4级的占14.7%；不稳定型心绞痛患者占14.7%，急性心肌梗死患者占6.6%。在477处接受治疗的病变中，60%为B2型，19%为C型。病变分别位于左前降支（LAD）的占61%，左旋支（LCX）的占16%，右冠状动脉（RCA）的占20%，受保护的左主干的占1.3%，大隐静脉桥血管的占2.5%。激光血管成形术失败发生在56例（12%）干预中。多因素分析显示，失败与治疗长节段病变的意向（风险比（RR）3.6，置信区间（CI）2.9至4.4；P = 0.0005）、严重狭窄前迂曲节段（RR 3.5，CI 2.4至4.6；P = 0.02）和完全闭塞（RR 2.1；CI 1.4至2.8；P = 0.05）相关。并发症包括血管痉挛（13.4%）、夹层（14.7%）、限流性夹层（4%）、再闭塞（7.8%）和穿孔（1.9%）。心肌梗死发生率为2.1%，需要进行冠状动脉旁路移植术（CABG）的占1.9%，死亡率为1.5%。手术成功率为89%。手术成功率降低的个体形态学标准为存在血栓（RR 6.4；CI 5.0至7.7；P = 0.007）和血管钙化（RR 2.6；CI 1.9至3.2；P = 0.005）。C型病变的手术成功率（86%）略低于B2型（88%）、B1型（95%）和A型病变（92%）。（摘要截断于250字）
