Leone A, Bertanelli F, Mori L, Fabiano P, Bertoncini G
Division of Medicine & Cardiology, City Hospital, Pontremoli, Italy.
Singapore Med J. 1993 Apr;34(2):118-20.
We studied coronary artery specimens histologically in 96 patients who died from acute myocardial infarction(AMI), to assess those who could benefit from in-hospital percutaneous transluminal coronary angioplasty (PTCA). For the left anterior descending artery, old stenoses within 1 cm from its origin in 80 cases (83.3%), coronary narrowing over 90% and occlusive thrombi in 40 observations (41.6%) were seen. Left main artery showed proximal stenoses with an occlusive thrombus in 4 cases (41.6%). Left circumflex artery had stenoses within 1 cm from its origin in 32 cases (33.3%), with an occlusive thrombus 6 times (6.25%) and coronary narrowing 75%. Right coronary artery showed stenoses in the proximal and midportion respectively in 20 (20.8%) and 36 cases (37.5%), with 26 occlusive thrombi (27%) and coronary narrowing 85%. Four cases (4.16%) had minimal coronary changes. The patients who had one, two and three vessel disease were 32 (33.3%), 32 (33.3%) and 28 times (29.16%) respectively. Only one-third of patients could benefit from PTCA.
我们对96例死于急性心肌梗死(AMI)的患者的冠状动脉标本进行了组织学研究,以评估那些能从住院期间经皮腔内冠状动脉成形术(PTCA)中获益的患者。对于左前降支,在80例(83.3%)中,距其起源1厘米内可见陈旧性狭窄,40例(41.6%)观察到冠状动脉狭窄超过90%且有闭塞性血栓。左主干动脉有4例(41.6%)显示近端狭窄并伴有闭塞性血栓。左旋支动脉在32例(33.3%)中距其起源1厘米内有狭窄,6例(6.25%)有闭塞性血栓且冠状动脉狭窄75%。右冠状动脉分别在20例(20.8%)和36例(37.5%)中显示近端和中段狭窄,有26例闭塞性血栓(27%)且冠状动脉狭窄85%。4例(4.16%)冠状动脉变化极小。单支血管病变、双支血管病变和三支血管病变的患者分别为32例(33.3%)、32例(33.3%)和28例(29.16%)。只有三分之一的患者能从PTCA中获益。