Angelini P, Hernandez C, Ferguson J J, Leachman R D, Garcia-Gregory J A, Benrey J, Schnee M J, Fighali S F, Krajcer Z
Department of Adult Cardiology, St. Luke's Episcopal Hospital, Houston, Texas, USA.
Tex Heart Inst J. 1996;23(1):15-23.
We assessed the effectiveness of distal hemoperfusion support during gradual, prolonged balloon inflation during percutaneous transluminal coronary angioplasty in high-risk patients. The patients were identified as having a poor left ventricular ejection fraction ( < 35%), > 50% of viable myocardium at risk percutaneous coronary balloon angioplasty, or both. A total of 64 procedures were performed in 61 patients. Angiographic success was achieved in 83 of 86 (96.5%) lesions treated with hemoperfusion support. Hospital complications included 1 patient who had a non-Q-wave infarction, 1 who had to undergo redo percutaneous coronary balloon angioplasty, and 5 who required coronary artery bypass operations. The hospital mortality was 7.8% (5 patients). This preliminary study indicates that hemoperfusion support can enable expeditious, simple, economical, and effective percutaneous transluminal coronary balloon angioplasty in a subset of labile patients in whom procedural failure frequently leads to sudden death.
我们评估了在高危患者经皮腔内冠状动脉成形术期间逐渐延长球囊充盈时间时远端血液灌注支持的有效性。这些患者被确定为左心室射血分数低（<35%）、经皮冠状动脉球囊成形术时超过50%的存活心肌处于危险中，或两者兼有。61例患者共进行了64次手术。在接受血液灌注支持治疗的86个病变中，83个（96.5%）实现了血管造影成功。医院并发症包括1例发生非Q波梗死的患者、1例必须再次进行经皮冠状动脉球囊成形术的患者以及5例需要冠状动脉搭桥手术的患者。医院死亡率为7.8%（5例患者）。这项初步研究表明，血液灌注支持能够在一部分不稳定患者中实现快速、简单、经济且有效的经皮腔内冠状动脉球囊成形术，在这些患者中手术失败常常导致猝死。
