冠状动脉旁路移植术后病变桥血管的介入治疗

目的探讨冠状动脉旁路移植(CABG)术后移植血管病变介入治疗的效果。方法对CABG术后旁路移植血管的病变进行介入治疗。术后即刻进入临床随访,记录心脏事件的发生,患者术后6个月复查造影。结果对66例患者的74支病变桥血管(83处病变)进行了介入治疗,造影成功率为96.97%(64/66),临床成功率95.45%(63/66)。术中出现无复流现象2例,1例经处理恢复血流,1例处理无效。远端栓塞1例,D型夹层造成血管急性闭塞1例,重新置入支架后成功。住院期间无心脏事件发生。64例患者完成6个月的临床随访,心脏事件发生率为31.3%(20/64)。37例患者接受了造影检查,支架内再狭窄发生率为32.5%(13/40)。结论桥血管病变的介入治疗是可行、安全和有效的。

Percutaneous intervention of diseased grafts in post-CABG patients

Objective To evaluate the outcome of percutaneous intervention for the diseased bypass grafts in patients with previous coronary artery bypass graft surgery (CABG).Methods Sixty-six patients with diseased grafts after CABG underwent percutaneous intervention between July 2003 and July 2004.Angiographic follow up was suggested to all patients and major adverse cardiac events(MACE,including death,acute myocardial infarction and target lesion revascularization)were recorded within 6 months of follow up.Results Sixty-six patients with 74 diseased grafts(83 lesions) underwent percutaneous intervention.The angiographic success rate was 96.97%((64/66)) and the procedural success rate was 95.45%(63/66).No reflow phenomenon occurred in 2 cases,1 case restored TIMI 3 flow after administering verpamil but the other patient failed to restore the blood flow. Distal embolization occurred in 1 case.Abrupt closure in 1 case because of Dtype dissection not treated during the procedure but TIMI 3 flow was obtained after repairment with another stent.No MACE(death,acute myocardial infarction and acute emergency revascularization) occurred during hospitalization and the incidence of MACE was 31.3%(20/64) at 6 months follow up.In-segment restenosis rate was 32.5%(13/40) in 37 patients with angiographic follow-up.Conclusion Percutaneous intervention for diseased bypass grafts is feasible,safe and effective.