Trevi G P, Sheiban I
Scuola di specializzazione in Cardiolgia, Università G. D'Annunzio, Chieti.
Recenti Prog Med. 1993 Nov;84(11):779-85.
Coronary angioplasty (PTCA) represents a valid alternative to coronary artery bypass surgery (CABG) in several cases; moreover, PTCA might be performed, for myocardial revascularization, even in patients in whom CABG is transitory or definitely contraindicated. However, the guidelines for mechanical myocardial revascularization are still mainly based on clinical criteria and the only angiographic data should not be sufficient to extend the indications for PTCA. Despite the technical improvement of the procedure and the material used, PTCA continues to have two main limitations: the relatively high acute complications rate (4-7%) and long-term restenosis rate (20-40%). The advent of new techniques for myocardial revascularizations (transluminal atherectomy, coronary stents, laser angioplasty) might partially reduce these limitations.
在某些情况下，冠状动脉血管成形术（PTCA）是冠状动脉旁路移植术（CABG）的一种有效替代方法；此外，即使在CABG暂时或绝对禁忌的患者中，为实现心肌血运重建也可进行PTCA。然而，机械性心肌血运重建的指南仍主要基于临床标准，仅靠血管造影数据不足以扩大PTCA的适应证。尽管该手术及所用材料的技术有所改进，但PTCA仍有两个主要局限性：相对较高的急性并发症发生率（4 - 7%）和长期再狭窄率（20 - 40%）。用于心肌血运重建的新技术（腔内斑块旋切术、冠状动脉支架、激光血管成形术）的出现可能会部分减少这些局限性。
