el Gaylani N, McAdam B F, White U, Gearty G F, Walsh M J, Crean P A
Dept. of Cardiology, St. James's Hospital, Dublin.
Ir Med J. 1996 Mar-Apr;89(2):60-1.
In a series of 129 patients having coronary angioplasties in St. James's Hospital in 1989, the average age was 54.8 (30-77 years). There were 102 (79%) men and 27 (21%) females. Clinical indications were unstable angina 62, stable angina 26, post myocardial infarction 39 and asymptomatic ischaemia 2. The distribution of coronary disease was single vessel 62%, double vessel 28%, triple vessel 7% and previous coronary bypass surgery 3%. Only 10 patients had more than one vessel dilated. Primary success was achieved in 119 (92%), there were no deaths, 3 patients had abrupt closure of the vessel during angioplasty and sustained a nonfatal myocardial infarction, 1 patient required urgent bypass surgery and 2 patients had peripheral vascular complications requiring surgery. There were 6 failed angioplasties, 4 of which had chronic total occlusion. At a mean follow-up of 5.3 months, 85 patients had no symptoms, 34 had angina, 2 developed myocardial infarction and 1 died suddenly at 5 months. Repeat angiography was performed in 96 (79%) patients. At follow-up, no symptoms were present in 69% of those with single vessel disease and 70% of multivessel disease. Of those who had more than one vessel dilated in multivessel disease, 80% were asymptomatic (P = NS). There were 11 patients with initial total occlusion at presentation, 4 had failed angioplasties, 5 recurrent angina of which 4 reoccluded and 1 restenosed and only 2 were asymptomatic and without restenosis. Angioplasty was performed with primary success (92%) and follow up results (70% asymptomatic). Those with single or multivessel disease had similar clinical outcome, favouring the use of target vessel angioplasty. Long term results following angioplasty of chronic total occlusions were poor and suggests the need for additional treatment.
1989年在圣詹姆斯医院接受冠状动脉血管成形术的129例患者中，平均年龄为54.8岁（30 - 77岁）。其中男性102例（79%），女性27例（21%）。临床指征为不稳定型心绞痛62例，稳定型心绞痛26例，心肌梗死后39例，无症状性心肌缺血2例。冠状动脉疾病分布为单支血管病变62%，双支血管病变28%，三支血管病变7%，既往有冠状动脉搭桥手术史3%。仅10例患者有多支血管扩张。119例（92%）获得初步成功，无死亡病例，3例患者在血管成形术期间血管突然闭塞并发生非致命性心肌梗死，1例患者需要紧急搭桥手术，2例患者有需要手术治疗的外周血管并发症。有6例血管成形术失败，其中4例为慢性完全闭塞。平均随访5.3个月时，85例患者无症状，34例有胸痛，2例发生心肌梗死，1例在5个月时突然死亡。96例（79%）患者进行了重复血管造影。随访时，单支血管病变患者中69%无症状，多支血管病变患者中70%无症状。在多支血管病变中接受多支血管扩张的患者中，80%无症状（P = 无显著性差异）。有11例患者初诊时为完全闭塞，4例血管成形术失败，5例复发心绞痛，其中4例再闭塞，1例再狭窄，仅2例无症状且无再狭窄。血管成形术初步成功率为（92%），随访结果（70%无症状）。单支或多支血管病变患者的临床结局相似，支持采用靶血管血管成形术。慢性完全闭塞血管成形术后的长期结果较差，提示需要额外治疗。
