Kurbaan A S, Bowker T J, Rickards A F
Department of Cardiology, Royal Brompton Hospital/National Heart & Lung Institute, London, United Kingdom.
Am Heart J. 1998 Apr;135(4):703-8. doi: 10.1016/s0002-8703(98)70289-3.
Restenosis is a major limitation of angioplasty. In this analysis we assessed the effects of lesion site and quality of dilatation on restenosis rate in the Coronary Angioplasty versus Bypass Revascularization Investigation population who underwent angioplasty.
The angiographic quality of the successful angioplasty revascularization at each site was assessed, and the subsequent restenosis rate was determined. Restenosis was defined by the need for a second angioplasty at the initial site or by surgical coronary bypass grafting at or distal to the initial site.
The restenosis rate was unaffected by quality of dilatation but was significantly more common in the proximal left anterior descending artery compared with other sites, whether or not optimal dilatation had been achieved (relative risk 2.0 and 1.9, respectively).
Revascularization strategies in multivessel disease should consider the presence or absence of a proximal left anterior descending artery target. Furthermore in studies in which restenosis is an outcome of interest, an allowance should be made for the distribution of target disease.
再狭窄是血管成形术的主要限制因素。在本分析中，我们评估了病变部位和扩张质量对接受血管成形术的冠状动脉血管成形术与搭桥血运重建研究人群再狭窄率的影响。
评估每个部位成功的血管成形术血运重建的血管造影质量，并确定随后的再狭窄率。再狭窄定义为在初始部位需要进行第二次血管成形术，或在初始部位或其远端进行外科冠状动脉搭桥术。
再狭窄率不受扩张质量的影响，但与其他部位相比，在左前降支近端再狭窄明显更常见，无论是否实现了最佳扩张（相对风险分别为2.0和1.9）。
多支血管疾病的血运重建策略应考虑是否存在左前降支近端靶病变。此外，在以再狭窄为感兴趣结局的研究中，应考虑靶病变的分布情况。
