冠状动脉旁路移植术后旁路移植血管病变介入治疗的临床疗效

Clinical results of percutaneous intervention in saphenous venous graft and arterial graft lesions in patients with restenosis of previous coronary artery bypass surgery

目的 探讨旁路移植血管病变的特点及介入治疗旁路移植血管病变的临床疗效。方法 对 30例 35处旁路移植血管病变行介入治疗 ,其中大隐静脉移植血管病变 31处 ,内乳动脉移植血管病变 4处。结果 临床成功率为 96 7% ,病变的成功率为 97 1% ,无再流发生率为 7 4 % ,术中和住院期间无一例死亡 ,1例术后发生急性心肌梗死与无再流有关 ,住院期间并发症 (死亡、急性心肌梗死、紧急血管重建 )发生率仅为 3 3%。结论 本研究结果提示介入治疗旁路移植血管病变是冠状动脉旁路移植术后心肌缺血的有效治疗手段。

Objective The aim of this study was to evaluate the lesion characteristics of coronary artery bypass grafts and technical factors related to successful percutaneous intervention procedure. Methods Percutaneous intervention was performed in 35 lesions including 31 SVGs and 4 LIMA in 30 patients with previous coronary artery bypass grafting. Results Procedural success rate of percutaneous intervention was 97 1% (34/35). No reflow occurred during the procedure in 7 4%. There was no death during the procedure and hospitalization. One patient had acute myocardial infarction which caused by no reflow after the stenting. The complication rate (death, AMI & emergency revascularization) during hospitalization was only 3 3%. Conclusion This study demonstrates that percutaneous intervention for veinous graft and arterial graft lesions is a very fast and effective method, and is considered as first treatment choice for myocardial ischemia after CABG.