连续605例择期经皮冠状动脉腔内成形术并发症的再分析(摘要)
作者：马长生 颜红兵 王勇 周玉杰 李宪伦 郑知刚 李宵 柯元南
单位：北京市，中日友好医院 心内科(100029)
关键词：
中国循环杂志99zk32 目的：回顾性分析连续605例择期经皮冠状动脉腔内成形术(PTCA)支架置入术的并发症，以提高预防和处理有关并发症的能力。
方法：1994年至1999年共对605例782处病变行择期PTCA/支架置入术，男532例，女73例，平均年龄56岁。其中1995年8月以后在327例397处病变行支架置入术。稳定性心绞痛266例，不稳定性心绞痛139例，急性心肌梗塞恢复期128例，陈旧性心肌梗塞72例。A型病变141处，B1型病变258处，B2型病变298处，C型病变85处。单支病变230例，二支病变308例，三支病变67例(左心室射血分数≤0.40?21例)。按常规操作完成血管造影和PTCA/支架置入。术后常规抗凝治疗。
, 百拇医药
结果：在605例782处病变行择期PTCA/支架置入术，成功率为95.2%,支架置入成功率为99%。在327例397处病变共置入15种425个支架。严重并发症包括死亡(0.5%)、Q波心肌梗塞(0.8%)、紧急冠状动脉旁路移植(0.17%)、急性闭塞或严重夹层(4.3%)和冠状动脉穿孔致心包填塞0.33%,非严重并发症有边支闭塞(1.65%)、心室颤动(0.83%)、急诊二次介入(0.17%)和血管并发症(0.33%)。
结论：在严格掌握适应证并由易到难开展PTCA工作的原则下：择期PTCA/支架置入术治疗冠状动脉狭窄的成功率高，严重并发症和非严重并发症发生率低，因而是一种安全、有效的治疗方法。广泛应用支架置入术使PTCA复杂病例增加，成功率进一步提高。主动脉内球囊反搏和心外科支持，有助于对复杂病例施行PTCA。
Reanalysis of Complications of Elective Percutaneous Transluminal Coronary Angioplasty in 605 Patients (Abstract)
, 百拇医药
Department of Cardiology, China-Japan Friendship Hospital, Beijing (100029)
Ma Changsheng, Yan Hongbing, Wang Yong, et al.
Objective: To improve our ability of prevention and management of complications of elective percutaneous transluminal coronary angioplasty (PTCA)/coronary stenting by retrospective analyzing of them in 605 consecutive patients.
Methods: From 1994 to June 1999, 782 stenosis in 605 patients were treated with PTCA/coronary stenting in this hospital. Of them, 397 stenosis in 327 patients were treated with coronary stent implantation. They were 532 males and 73 females with an average age of 56 years. There were stable angina pctoris in 266 patients, unstable angina in 139, convalescent acute myocardial infarction (AMI) in 128 and OMI in 72. Of 397 stenosis, 141 type A lesions, 258 type B1 lesions, 298 type B2 lesions and 85 type C lesions were observed with single vessel lesions in 230 patients, two-vessel lesions in 308 and three-vessel lesions in 67 (LVEF≤0.40 in 21). All patients underwent anticoagulation/antiplatelet therapy, PTCA/stenting procedures following the ACC/AHA guideline.
, http://www.100md.com
Results: With technical success in 95.2% and successful stent implantation in 99%, 782 stenosis in 605 patients were treated with PTCA/coronary stenting (425 coronary stents of 15 kinds in 397 stenosis in 327 patients). Encountered major complications included death (0.5%), Q wave-MI (0.8%), emergency bypass surgery (0.17%), acute closure or severe dissection (4.3%) and cardiac tamponade resulting from coronary artery perforation (0.33%); and minor complications were side branch occlusion (1.65%), VF (0.83%), secondary emergency intervention (0.17%) and vascular complications (0.33%).
, 百拇医药
Conclusion: Elective PTCA/ stenting for coronary artery stenosis can be performed with a higher success rate and a lower incidence of major and minor complications, it presupposes that careful indication selection and starting practice on simple cases are the necessary principles should be observed strictly, and consequently it is a safe and effective treatment modality. A wide application of coronary stenting technique has resulted in an increase of complicated PTCA cases and improved success rate. With intra-aortic balloon pumping (IABP) and cardiac surgery support, a successful PTCA procedure may be achieved in very complicated cases., 百拇医药
单位：北京市，中日友好医院 心内科(100029)
关键词：
中国循环杂志99zk32 目的：回顾性分析连续605例择期经皮冠状动脉腔内成形术(PTCA)支架置入术的并发症，以提高预防和处理有关并发症的能力。
方法：1994年至1999年共对605例782处病变行择期PTCA/支架置入术，男532例，女73例，平均年龄56岁。其中1995年8月以后在327例397处病变行支架置入术。稳定性心绞痛266例，不稳定性心绞痛139例，急性心肌梗塞恢复期128例，陈旧性心肌梗塞72例。A型病变141处，B1型病变258处，B2型病变298处，C型病变85处。单支病变230例，二支病变308例，三支病变67例(左心室射血分数≤0.40?21例)。按常规操作完成血管造影和PTCA/支架置入。术后常规抗凝治疗。
, 百拇医药
结果：在605例782处病变行择期PTCA/支架置入术，成功率为95.2%,支架置入成功率为99%。在327例397处病变共置入15种425个支架。严重并发症包括死亡(0.5%)、Q波心肌梗塞(0.8%)、紧急冠状动脉旁路移植(0.17%)、急性闭塞或严重夹层(4.3%)和冠状动脉穿孔致心包填塞0.33%,非严重并发症有边支闭塞(1.65%)、心室颤动(0.83%)、急诊二次介入(0.17%)和血管并发症(0.33%)。
结论：在严格掌握适应证并由易到难开展PTCA工作的原则下：择期PTCA/支架置入术治疗冠状动脉狭窄的成功率高，严重并发症和非严重并发症发生率低，因而是一种安全、有效的治疗方法。广泛应用支架置入术使PTCA复杂病例增加，成功率进一步提高。主动脉内球囊反搏和心外科支持，有助于对复杂病例施行PTCA。
Reanalysis of Complications of Elective Percutaneous Transluminal Coronary Angioplasty in 605 Patients (Abstract)
, 百拇医药
Department of Cardiology, China-Japan Friendship Hospital, Beijing (100029)
Ma Changsheng, Yan Hongbing, Wang Yong, et al.
Objective: To improve our ability of prevention and management of complications of elective percutaneous transluminal coronary angioplasty (PTCA)/coronary stenting by retrospective analyzing of them in 605 consecutive patients.
Methods: From 1994 to June 1999, 782 stenosis in 605 patients were treated with PTCA/coronary stenting in this hospital. Of them, 397 stenosis in 327 patients were treated with coronary stent implantation. They were 532 males and 73 females with an average age of 56 years. There were stable angina pctoris in 266 patients, unstable angina in 139, convalescent acute myocardial infarction (AMI) in 128 and OMI in 72. Of 397 stenosis, 141 type A lesions, 258 type B1 lesions, 298 type B2 lesions and 85 type C lesions were observed with single vessel lesions in 230 patients, two-vessel lesions in 308 and three-vessel lesions in 67 (LVEF≤0.40 in 21). All patients underwent anticoagulation/antiplatelet therapy, PTCA/stenting procedures following the ACC/AHA guideline.
, http://www.100md.com
Results: With technical success in 95.2% and successful stent implantation in 99%, 782 stenosis in 605 patients were treated with PTCA/coronary stenting (425 coronary stents of 15 kinds in 397 stenosis in 327 patients). Encountered major complications included death (0.5%), Q wave-MI (0.8%), emergency bypass surgery (0.17%), acute closure or severe dissection (4.3%) and cardiac tamponade resulting from coronary artery perforation (0.33%); and minor complications were side branch occlusion (1.65%), VF (0.83%), secondary emergency intervention (0.17%) and vascular complications (0.33%).
, 百拇医药
Conclusion: Elective PTCA/ stenting for coronary artery stenosis can be performed with a higher success rate and a lower incidence of major and minor complications, it presupposes that careful indication selection and starting practice on simple cases are the necessary principles should be observed strictly, and consequently it is a safe and effective treatment modality. A wide application of coronary stenting technique has resulted in an increase of complicated PTCA cases and improved success rate. With intra-aortic balloon pumping (IABP) and cardiac surgery support, a successful PTCA procedure may be achieved in very complicated cases., 百拇医药