冠状动脉造影后即刻PTCA与择期PTCA的比较

Percutaneous transluminal coronary angioplasty immediately after coronary angiography compared with selective coronary angioplasty

目的 研究冠状动脉造影后即刻冠状动脉成形术的成功率及并发症率进而探讨其临床应用价值。方法 对冠状动脉造影后即刻冠脉成形术及靶病变特点与其相似的择期冠脉成形术各７０ 例进行对比分析。结果 Ａ 和Ｂ型病变的成功率和并发症率两组间差异无显著性，Ｃ型病变的成功率即刻组低于择期组（５７．１４％ 对９２．８６％ ，Ｐ＜ ０．０５）而并发症率高于择期组（５７．１４％ 对１４．２９％ ，Ｐ＜ ０．０１），闭塞性病变的成功率及并发症率两组间差异无显著性。结论 Ｃ型病变不宜于造影后即刻行冠脉成形术。闭塞性病变可于造影后即刻试行冠脉成形以避免次全闭塞进展为完全闭塞后才进行手术。

Objective To study the success rate and complication rate of percutaneous transluminal coronary angioplasty (PTCA) immediately after coronary angiography, and to estimate its clinical evaluation Methods Seventy patients who underwent PTCA immediately after coronary angiography (Group 1) were compared with 70 patients on whom PTCA and coronary angiography were performed in two different selective days (Group 2) The clinical manifestations and target lesion characteristics of these two groups were similar Results The success rates and complication rates of types A and B lesions were not significantly different between the two groups ( P <0 05) The success rate of type C lesions in group 1 was lower than that in group 2 (57 14% vs 92 86%, P <0 05) The complication rate of type C lesions in group 1 was higher than that in group 2 (57 14% vs 14 29%, P <0 01) The success rates and complication rates of occlusive lesions between the two groups were not significantly different Conclusions Type C lesions were not suitable to PTCA immediately after coronary angiography PTCA can be tried immediately after coronary angiography on occlusive lesions, this may avoid a subtotally occlusive lesion to aggravate to a totally occlusive one So PTCA imediately after coronary angiography has some extent of clinical evaluation