Brekke M, Kuiper K
Avdeling for hjerte- og karradiologi, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1998 Feb 20;118(5):729-32.
Percutaneous transluminal coronary angioplasty is the most commonly used method for coronary revascularization in Norway. More than 3,500 procedures were performed in 1997. The presence of atherosclerotic endothelium is a strong stimulus to increased haemostasis. During balloon angioplasty, activation of the coagulation system is further increased by the trauma caused to the vessel wall. Major complications associated with coronary angioplasty include vessel occlusion, myocardial infarction, and periprocedural death. Most early complications occur as a result of the formation of a thrombus at the angioplasty site. Effective antithrombotic treatment is essential to reduce the risk of thromboembolic complications during and after percutaneous transluminal coronary angioplasty with or without stent implantation. All patients should be treated in advance with acetylsalicylic acid. Heparin must be given during the procedure. After stent implantation the patient should be treated with a combination of the two antiplatelet agents acetylsalicylic acid and ticlopidine. This article presents the current practice for using antithrombotic medication in percutaneous transluminal coronary angioplasty.
经皮腔内冠状动脉成形术是挪威最常用的冠状动脉血运重建方法。1997年进行了超过3500例该手术。动脉粥样硬化内皮的存在是促进止血增加的强烈刺激因素。在球囊血管成形术期间，血管壁受到的创伤会进一步增加凝血系统的激活。与冠状动脉血管成形术相关的主要并发症包括血管闭塞、心肌梗死和围手术期死亡。大多数早期并发症是由于血管成形术部位形成血栓所致。有效的抗栓治疗对于降低在有或没有植入支架的经皮腔内冠状动脉成形术期间及术后血栓栓塞并发症的风险至关重要。所有患者均应预先使用乙酰水杨酸进行治疗。手术期间必须给予肝素。植入支架后，患者应联合使用乙酰水杨酸和噻氯匹定这两种抗血小板药物进行治疗。本文介绍了经皮腔内冠状动脉成形术中使用抗栓药物的当前做法。
