Kawata T, Hasegawa J, Yoshida Y, Nakayama Y, Kawachi K, Kitamura S
Department of Surgery III, Nara Medical College, Japan.
Kyobu Geka. 1994 Jun;47(6):434-7.
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.
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。