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主动脉先天性缩窄球囊血管成形术的随访结果

Follow-up results of balloon angioplasty for native coarctation of aorta.

作者信息

Biswas P K, Mitra K, De S, Banerjee A K, Roy S, Das Biswas A, Biswas A, Chatterjee S S, Maity A K

机构信息

Institute of Post Graduate Medical Education & Research, Calcutta.

出版信息

Indian Heart J. 1996 Nov-Dec;48(6):673-6.

PMID:9062016
Abstract

Balloon angioplasty of native discrete (< 1 cm) coarctation of thoracic aorta was performed in 29 patients [aged 13 to 31 years (mean 21.5 +/- 5.8 years), 22 males and 7 females], from March 1993 to December 1995. The patients were followed up for two years. After angioplasty, peak systolic arterial pressure (PSAP) decreased from 173.5 +/- 18.1 mm Hg to 122.5 +/- 9.9 mm Hg (p < 0.001), peak systolic pressure gradient (PSG) decreased by 90.9 percent from 86.2 +/- 15.77 to 7.77 +/- 3.8 mm Hg (p < 0.001) and the coarcted segment diameter increased about three times from 3.7 +/- 1.6 to 10.9 +/- 3.3 mm (p < 0.001). PSG decreased to < 10 mm Hg in 27 patients (93%) whereas in the other two patients PSG was 17 and 13 mm Hg. Restenosis appeared in 2 patients (6.8%); aneurysm in one patient (3.4%) which remained static even after 1.3 years of follow-up; mild dissection in 3 patients (10.3%); temporary femoral artery occlusion in 2 (6.8%) patients who recovered with heparin injection. Though hypertension disappeared after balloon dilatation in all patients, it reappeared in 3 patients (10.3%) within 7 days and in 10 patients (34.5%) within 6 months. In conclusion, balloon angioplasty of CoA is a good alternative to surgical correction.

摘要

1993年3月至1995年12月,对29例患者[年龄13至31岁(平均21.5±5.8岁),男22例,女7例]进行了胸主动脉局限性(<1 cm)先天性缩窄的球囊血管成形术。对这些患者进行了两年的随访。血管成形术后,收缩期动脉压峰值(PSAP)从173.5±18.1 mmHg降至122.5±9.9 mmHg(p<0.001),收缩期压力阶差峰值(PSG)从86.2±15.77 mmHg降至7.77±3.8 mmHg,下降了90.9%(p<0.001),缩窄段直径从3.7±1.6 mm增加至约3倍,即10.9±3.3 mm(p<0.001)。27例患者(93%)的PSG降至<10 mmHg,而另外2例患者的PSG分别为17 mmHg和13 mmHg。2例患者(6.8%)出现再狭窄;1例患者(3.4%)出现动脉瘤,即使在随访1.3年后仍保持稳定;3例患者(10.3%)出现轻度夹层;2例患者(6.8%)出现股动脉暂时性闭塞,经肝素注射后恢复。虽然所有患者在球囊扩张后高血压消失,但3例患者(10.3%)在7天内复发,10例患者(34.5%)在6个月内复发。总之,先天性主动脉缩窄的球囊血管成形术是手术矫正的良好替代方法。

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