Results of percutaneous transluminal coronary angioplasty of high-risk angulated stenoses.
Results of percutaneous transluminal coronary angioplasty of high-risk angulated stenoses.
复制标题
高风险成角狭窄的经皮腔内冠状动脉成形术的结果。
DOI：
10.1016/0002-9149(90)90928-t
复制
发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Topol,EJ
中科院分区：
文献类型：
--
作者：
Ellis,SG;Topol,EJ
经皮冠状动脉腔内成形术(PTCA)对成角狭窄的研究发现，使用较旧的PTCA设备与手术相关的重大缺血事件的高风险相关。为了更好地了解与手术风险相关的因素并确定降低风险的方法，从1986年到1989年连续治疗的100例患者接受了≥45°弯曲处狭窄的经皮冠状动脉腔内成形术，分析了27个临床、解剖和程序变量。血管成形术的临床结果与这些变量有关。此外，对连续344例接受PTCA治疗的非角度病变患者的结果与研究组的结果进行了比较。有角度狭窄的患者手术成功率仅为70%，而无角度狭窄的患者有306例(89%)，且有13%的有角度狭窄的患者发生了严重的缺血并发症(死亡、搭桥手术或心肌梗死)，而有无角度狭窄的患者中有12例(3.5%)发生了严重的缺血并发症(P均<0.001)。合并血栓、狭窄长度<10 mm或年龄≥65岁的患者发生严重并发症的风险更高(9/44=20.5%)，而经验丰富的血管成形术操作员和使用聚对苯二甲酸乙二醇酯气球似乎降低了风险并增加了成功的可能性。此类狭窄的经皮冠状动脉腔内成形术(PTCA)应该只在仔细挑选的患者中进行。
Percutaneous transluminal coronary angioplasty (PTCA) of angulated stenoses has been found in studies using older PTCA equipment to be associated with a heightened risk of procedure-related major ischemic events. To better understand the factors associated with procedural risk and to identify means of lessening that risk, 100 patients, treated sequentially from 1986 to 1989, who underwent PTCA of stenoses located at ≥45 ° bends, were characterized for 27 clinical, anatomic and procedural variables. Clinical outcome of angioplasty was related to these variables. In addition, results from 344 consecutive contemporary patients undergoing PTCA of nonangulated lesions were compared to those of the study group. Procedural success was achieved in only 70% of patients with angulated stenoses, compared with 306 of 344 (89%) nonangulated stenoses, and major ischemic complications (death, bypass surgery or myocardial infarction) occurred in 13% of patients with angulated stenoses compared with 12 of 344 (3.5%) with nonangulated stenoses (both p < 0.001). The presence of associated thrombus, stenosis length >10 mm or age ≥65 years led to an even higher risk of major complications (9 of 44 = 20.5%), whereas highly experienced angioplasty operators and the use of polyethylene terephthalate balloons appeared to decrease risk and increase the likelihood of success. PTCA of such stenoses should be undertaken only cautiously and in carefully selected patients.
登录
查看更多内容
70 岁及以上心绞痛患者经皮腔内冠状动脉成形术的早期和长期结果。
DOI：
10.1016/0002-9149(88)90901-0
发表时间：
1988
期刊：
The American journal of cardiology
影响因子：
--
作者：
C. Simpfendorfer;R. Raymond;J. Schraider;K. Badhwar;K. Dorosti;I. Franco;J. Hollman;P. Whitlow
通讯作者：
P. Whitlow
影响因子：
24
作者：
Stephen G. Ellis;G. Roubin;S. King;J. Douglas;R. Shaw;S. Stertzer;R. Myler
通讯作者：
Stephen G. Ellis;G. Roubin;S. King;J. Douglas;R. Shaw;S. Stertzer;R. Myler
DOI：
10.1016/0735-1097(88)92593-4
发表时间：
1988-11-01
影响因子：
24
作者：
HOLMES, DR;HOLUBKOV, R;DETRE, K
通讯作者：
DETRE, K
八旬老人的经皮腔内冠状动脉成形术。
DOI：
10.1016/0002-9149(88)90304-9
发表时间：
1988
期刊：
The American journal of cardiology
影响因子：
--
作者：
M. Kern;U. Deligonul;K. Galan;R. Zelman;G. Gabliani;S. Bell;J. Bodet;K. Naunheim;M. Vandormael
通讯作者：
M. Vandormael
不稳定型心绞痛的冠状动脉血管成形术：200 名连续患者的即时和晚期结果，并确定了不利的早期和晚期结果的危险因素。
影响因子：
24
作者：
De Feyter;H. Suryapranata;P. Serruys;K. Beatt;R. V. Domburg;M. V. D. Brand;Jan J. Tijssen;Aida J. Azar;P. G. Hugenholtz
通讯作者：
P. G. Hugenholtz