Seiler C, Meier B
Departement Innere Medizin, Universitätsspital Bern.
Schweiz Med Wochenschr. 1996 Apr 6;126(14):559-65.
The risk of invasive cardiologic interventions being associated with morbid and mortal events is substantially related to the absolute numbers in whom these procedures are performed and this, in turn, is due to the epidemiologic significance of diseases of the cardiovascular system in industrialized countries. Diagnostic cardiac catheterization with coronary angiography is an invasive procedure with a relatively low risk of complications ( approximately 1%) or death (approximately 0.1%). Percutaneous transluminal coronary angioplasty (PTCA), on the other hand, carries a risk of complications of approximately 4% and has a mortality of approximately 1%. The major source of complications with intracoronary stent implantations relates to their thrombogenicity with acute or subacute closure of the vessel (rate of complications 6-15%, mortality approximately 2%). In vessels of < or = 3 mm in diameter, the restenosis rate of a stenotic lesion treated with a stent approximates that of conventional PTCA (one third). Patients with reduced left ventricular ejection fraction are at substantial risk if treated with drugs instead of bypass surgery (better long-term survival in the latter group.
侵入性心脏介入治疗与发病和死亡事件相关的风险，很大程度上与接受这些手术的绝对人数有关，而这又归因于工业化国家心血管系统疾病的流行病学意义。诊断性心脏导管插入术及冠状动脉造影是一种侵入性手术，并发症风险相对较低（约1%）或死亡风险（约0.1%）。另一方面，经皮腔内冠状动脉成形术（PTCA）的并发症风险约为4%，死亡率约为1%。冠状动脉内支架植入术的主要并发症来源与其血栓形成性有关，可导致血管急性或亚急性闭塞（并发症发生率6 - 15%，死亡率约2%）。在直径小于或等于3毫米的血管中，用支架治疗的狭窄病变的再狭窄率与传统PTCA相近（三分之一）。左心室射血分数降低的患者若接受药物治疗而非搭桥手术，会面临很大风险（后者组长期生存率更高）。
