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題名 | Double-Vessel Primary Angioplasty in Acute Inferior Myocardial Infarction--Is it a Feasible Therapeutic Modality?=對急性下心室壁心肌梗塞病患同時實施直接性二條冠狀動脈擴張術--此是否為一可行之治療方式? |
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作者 | 羅鴻舜; 陳孟麟; 王榮添; 邱恆正; 王石補; Lo, Hung-shun; Chen, Meng-ling; Ong, Eng-thiam; Chiou, Herng-cheng; Wang, Shih-pu; |
期刊 | Acta Cardiologica Sinica |
出版日期 | 20031200 |
卷期 | 19:4 2003.12[民92.12] |
頁次 | 頁243-252 |
分類號 | 416.262 |
語文 | eng |
關鍵詞 | 二條血管直接性冠狀動脈擴張術; 心肌梗塞; 梗塞相關血管; Double-vessel primary angioplasty; Myocardial infarction; Infarct-related artery; |
中文摘要 | 背景:現今而言,以直接性經皮穿刺冠狀動脈擴張術治療急性心肌梗塞病患,已被視為除了血栓溶解術以外之另類可行之治療選擇。然而,於急性心肌梗塞期間去擴張梗塞相關血管以外之冠狀動脈,至今仍被視為禁忌。本文的目的:在探討對急性下心室壁心肌梗塞病患,具有二條被視為與梗塞相關之血管,且都又極度狹窄的冠狀動脈,同時對這二條血管實施直接性冠狀動脈擴術之可行性。方法與結果:在此,我們報導三位急性下心室壁心肌梗塞病患,同時具有二條被視為梗塞相關之血管,且都又極度狹窄的冠狀動脈。因為病患都拒絕開刀,而我們又無法確定究竟是右冠狀動脈或左迴旋技為梗塞相關血管;我們同時且成功地對這二條血管實施直接性冠狀動脈擴張術(兩位在主動脈氣幫埔協助下)。結論:對某些選擇性之急性下心室壁心肌梗塞病患,對二條可能與梗塞相關,未完全阻塞卻又極度狹窄的冠狀動脈血管,同時實施直接性冠狀動脈氣球(支架)擴張術,在緊急之情況下,可為冠狀動脈繞道手術外之另類治療選擇。由於個案數目很小,這在技術上似乎可行之治療方式,仍然而需要更大規模的研究來驗證。 |
英文摘要 | Background: Primary percutaneous transluminal coronary angioplasty (PTCA) is preferred alternative to thrombolytic therapy in acute myocardial infarction (AMI). However, PTCA of vessels other than infarct-related artery (IRA) is still considered be contraindicated in the setting of AMI. This study was to assess the feasibility of double-vessel primary angioplasty in acute inferior MI with critical lesions involving both the right coronary artery (RCA) and the left circumflex (LCX) artery. Methods and Results: We herein describe three patients with acute inferior MI in whom two major coronary arteries (RCA and LCX) were high-grade stenotic simultaneously. These three patients all refused to undergo emergency coronary artery bypass grafting (CABG). Because we could not identify whether the RCA the LCX was the IRA, we successfully performed primary PTCA on these two coronary arteries with two patients supported by intra-aortic balloon pump (IABP). Conclusions: In acute inferior MI with non-occlusive high-grade stenotic lesions involving both the RCA and the LCX, double-vessel PTCA especially with stenting may provide an alternative to emergency CABG, and may be useful in selected patients who are poor surgical candidates due to co-morbidity or who refuse to undergo CABG. However, further large-scale randomized studies are needed to confirm these observations. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。