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Percutaneous Transluminal Angioscopy During Coronary Intervention

机译:冠状动脉介入治疗中的经皮腔内血管镜检查

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摘要

To investigate the feasibility of angioscopic-guided percutaneous transluminal coronary angioplasty and to elucidate the mechanism of efficacy of coronary stenting for acute myocardial infarction, we performed coronary angioscopy in 102 patients with stable angina or acute myocardial infarction. Thrombi and intimal flaps were observed in most patients after coronary angioplasty. Large intimal splits were seen in one third of patients. Stents were inserted in 10 patients who were revealed to have a large flap or protruding split to the inner lumen. Thrombolytic agents were administered in 2 patients with large thrombi. Additional treatments were required in 32% of patients. No acute myocardial infarction or unstable angina occurred in patients during hospitalization. Thus, angioscopy of the coronary lumen enables clinicians to determine the most appropriate and least risky coronary intervention strategy. In patients with acute myocardial infarction, angioscopy revealed occlusive or protruding thrombi in 34 of 35 patients. The protruding thrombi disappearedafter stenting. The frequency of large intimal flaps increasedafter predilatation with balloon, but these disappeared afterstenting. The present angioscopic study demonstrates that thecoronary stent compresses the occlusive or protruding thrombi andcovers the ruptured thrombogenic plaque Consequently,smooth-surfaced and wide vessel lumen are obtained.
机译:为了研究经血管镜引导的经皮腔内冠状动脉成形术的可行性,并阐明冠状动脉支架置入术对急性心肌梗死的疗效机制,我们对102例稳定型心绞痛或急性心肌梗死患者进行了冠脉造影。大多数患者在冠状动脉成形术后均观察到血栓和内膜瓣。三分之一的患者可见内膜大裂痕。在10名患者中插入了支架,这些患者显示皮瓣较大或向内腔突出。 2名大血栓患者使用了溶栓剂。 32%的患者需要其他治疗。住院期间未发生急性心肌梗塞或不稳定型心绞痛。因此,冠状动脉腔的血管镜检查使临床医生能够确定最合适,风险最小的冠状动脉介入治疗策略。在患有急性心肌梗塞的患者中,35例患者中有34例在血管镜检查下发现了闭塞或突出的血栓。突出的血栓消失了支架置入后。内膜大皮瓣的频率增加用气球预扩张后,但这些消失后支架。目前的血管镜研究表明冠状动脉支架压迫闭塞性或突出性血栓,覆盖破裂的血栓形成斑块获得光滑表面和宽的血管腔。

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