Lund G K, Nienaber C A, Hamm C W, Terres W, Kuck K H
Abteilung für Kardiologie, Medizinische Klinik und Poliklinik, Universitäts-Krankenhaus Eppendorf, Hamburg.
Dtsch Med Wochenschr. 1994 Feb 11;119(6):169-74. doi: 10.1055/s-2008-1058676.
Percutaneous transluminal coronary angioplasty (PTCA) immediately after elective diagnostic cardiac catheterization ("prima vista"-PTCA) was performed in 124 patients (group 1) with typical angina pectoris (96 men, 28 women; mean age 60 +/- 10 [25-86] years). In a case-control analysis the results and complications, as well as the volume of contrast media and amount of radiation exposure were compared with a group of patients with similar symptoms (group 2) who during the same period had undergone angiography at another hospital and subsequently PTCA in our department (96 men, 28 women; mean age 60 +/- 8 [39-78] years). The success rate in group 1 (122 of 138 stenoses: 92.1%) was similar to that in group 2 (122 of 138 stenoses: 88.4%). Complications (coronary artery dissection with occlusion, emergency operation, myocardial infarction) were rare in both groups (8 vs 5; difference not significant). But the combined procedure (group 1) used lower volumes of contrast medium (341 +/- 131 vs 250 +/- 113 ml; P < 0.001) and the cumulative fluoroscopic time was lower (33.7 +/- 19.5 vs 26.5 +/- 12.4 min; P < 0.002). With optimal logistic conditions, "prima vista"-PTCA under elective circumstances is a useful and patient-friendly alternative to the conventional two-session diagnostic and therapeutic procedures.
对124例典型心绞痛患者（第1组，其中男性96例，女性28例；平均年龄60±10[25 - 86]岁）在择期诊断性心导管检查后立即进行经皮腔内冠状动脉成形术（“初视” - PTCA）。在一项病例对照分析中，将第1组患者的结果、并发症、造影剂用量和辐射暴露量与同期在另一家医院接受血管造影并随后在我科接受PTCA的一组有类似症状的患者（第2组，其中男性96例，女性28例；平均年龄60±8[39 - 78]岁）进行比较。第1组的成功率（138处狭窄中有122处：92.1%）与第2组（138处狭窄中有122处：88.4%）相似。两组并发症（冠状动脉夹层伴闭塞、急诊手术、心肌梗死）均少见（8例对5例；差异无统计学意义）。但联合操作（第1组）使用的造影剂用量较少（341±131 vs 250±113 ml；P<0.001），累计透视时间也较短（33.7±19.5 vs 26.5±12.4分钟；P<0.002）。在最佳后勤条件下，择期情况下的“初视” - PTCA是传统两阶段诊断和治疗程序的一种有用且对患者友好的替代方法。
