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经皮腔内血管成形术治疗冠状动脉旁路移植血管狭窄:动脉移植血管与静脉移植血管在再狭窄及再次冠状动脉旁路移植术方面的比较

[Percutaneous transluminal angioplasty for stenosis of coronary artery bypass grafts: a comparison of arterial grafts versus vein grafts with regard to restenosis and re-do CABG].

作者信息

Kawata T, Hasegawa J, Yoshida Y, Nakayama Y, Kawachi K, Kitamura S

机构信息

Department of Surgery III, Nara Medical College, Japan.

出版信息

Kyobu Geka. 1994 Jun;47(6):434-7.

PMID:8207879
Abstract

Stenoses of ten arterial grafts and thirty-four venous grafts from previous coronary artery bypass grafting (CABG) were treated with percutaneous transluminal angioplasty. In all ten arterial grafts, stenosis occurred at the distal coronary anastomotic site (A-d). In vein grafts, stenosis occurred at the proximal aortic anastomotic site (V-p) in 10, at the graft body (V-b) in 9 and the distal coronary anastomotic site (V-d) in 10 vessels. The initial success rates of angioplasty were 89% (A-d), 100% (V-p), 89% (V-b) and 100% (V-d). The time period between CABG and angioplasty was significantly shorter for A-d (4 +/- 3.8 months) and V-d (8.1 +/- 9.9 months) groups than for V-p (56.9 +/- 35.7 months) or V-b (45.9 +/- 48.6 months) groups. The restenosis rates following angioplasty were 0% (A-d), 50% (V-p), 50% (V-b) and 0% (V-d). Repeat CABG surgery was required for restenosis in 2 patients of group V-p and V-b. Our experience suggests that angioplasty can be performed with a high success rate for stenosis at the distal anastomosis of either arterial or vein grafts after CABG.

摘要

对先前冠状动脉旁路移植术(CABG)中10条动脉移植物和34条静脉移植物的狭窄进行了经皮腔内血管成形术治疗。在所有10条动脉移植物中,狭窄发生在冠状动脉远端吻合部位(A-d)。在静脉移植物中,10条血管的狭窄发生在主动脉近端吻合部位(V-p),9条在移植物主体(V-b),10条在冠状动脉远端吻合部位(V-d)。血管成形术的初始成功率分别为89%(A-d)、100%(V-p)、89%(V-b)和100%(V-d)。A-d组(4±3.8个月)和V-d组(8.1±9.9个月)CABG与血管成形术之间的时间间隔明显短于V-p组(56.9±35.7个月)或V-b组(45.9±48.6个月)。血管成形术后的再狭窄率分别为0%(A-d)、50%(V-p)、50%(V-b)和0%(V-d)。V-p组和V-b组中有2例患者因再狭窄需要再次进行CABG手术。我们的经验表明,CABG术后动脉或静脉移植物远端吻合处狭窄的血管成形术成功率较高。

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