Biswas P K, Mitra K, De S, Banerjee A K, Roy S, Das Biswas A, Biswas A, Chatterjee S S, Maity A K
Institute of Post Graduate Medical Education & Research, Calcutta.
Indian Heart J. 1996 Nov-Dec;48(6):673-6.
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.
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。
