经皮冠状动脉腔内成形术治疗不稳定型心绞痛的初步体会

Preliminary observation of percutaneous transluminal coronary angioplasty in the treatment of unstable angina pectoris

目的 探讨不稳定型心绞痛 (U AP)患者在合理的药物治疗效果不佳时采用经皮冠状动脉 (冠脉 )腔内成形术 (PTCA)及冠脉内支架术治疗的临床应用价值。方法 对药物治疗疗效不佳的 U AP患者行冠脉造影术 ,根据冠脉造影结果对 2 8例患者的 33处病变进行介入性治疗 ,单支血管病变行 PTCA术 ,并酌情置入支架 ,对多支血管病变先判断“罪犯”血管 ,一般只处理“罪犯”血管。结果 手术成功率为 10 0 % ,病变狭窄程度由术前的 (87± 13) %降为术后的 (4± 10 ) % ,术后所有患者的心绞痛症状较术前明显减轻或消失 ,活动耐量显著增加。无严重并发症发生 ,随访期有 4例 (14.2 )复发心绞痛。结论 PTCA及冠脉内支架术治疗 UAP是一种安全。

Objective To investigate the clinical value of percutaneous transluminal coronary angioplasty and intracoronary stent in the treatment of unstable angina when the appropriate medication had taken.Method Twenty eight patients with 33 diseased coronary arteries were treated by intracoronary interventional technique.The balloon angioplasty and bail out stenting were performed in cases with one vessel lesion,but in patients with multivessel lesion the culprit vessel must be identified firstly and then treated.Results The acute operational successful rate was 100%,the stenosis level was reduced from (87±13)% pre PTCA to (4±10)% post PTCA.All patients had experienced improvement in angina pectoris after procedure.The exercise capacity was improved.No severe complication occurred.Four recurrent anginae pectoris (14.2%) were found in follow up.Conclusion PTCA with intracoronary stent is an effective and safe procedure to treat unstable angina.