冠状动脉介入治疗后的再闭塞和再狭窄
ThomasIschinger,胡大一
摘要(Abstract)：
<正> 冠状动脉球囊血管成形术后即刻的和非常早期的再闭塞之原因已经清楚.最常见的机制包括动脉粥样硬化斑块的机械性改变、导致闭塞的内膜撕裂、动脉壁内出血、急性血栓形成以及有时发生的扩张动脉段的痉挛.现代导管技术能够很好应付这些情况,措施包括“修复”受到创伤的血管壁,使用灌注导管恢复冠状动脉血流或者更持久的解决办法——使用血管内的支撑物(冠状动脉支架).偶尔,需要即刻冠状动脉旁路移植手术.可以预期,血管成形技术的不断发展最终将把急性血管闭塞的问题减少至最低程度.
关键词(KeyWords)：
基金项目(Foundation):
作者(Author): ThomasIschinger,胡大一
参考文献(References)：
- [1] Ischinger T. Factors influencing the rate of coronary artery occlusion and reocclusion. In: Schmutzler H.Rutsch W, Dougherty FC.eds.Limitation of infarct size. Berlin:Speinger Ver1ag,1989． 213～221
- [2] Sanz G, Pajaron A, Alegria E, et al. Prevention of early aortocoronary bypass occlusion by low dose aspirin and dipyridamole. Circulation.1990． 82:765．
- [3] Gavaghan T, Gebski V,Baron DW. Immediate postoperative aspirin improves vein graft patency early and late after coronary artery bypass graft surgery: a placebo contrulled randomized study. Circulation.1991． 83:1526．
- [4] Fitzgibbon G, Leach AJ,Kafka HP, Keon WJ. Coronary bypass graft fate: Longterm angiographic study. J Am Coll Cardiol.1991,17:1075．
- [5] Garrat KN, Edwards WD, Kaufmann UF,et al. Differential histopathology of primary atherosclerotic and restenotic lesions in coronary arteries and saphenous vein bypass grafts: Analysis of tissue obtained from 73 patients by directional atherectomy. J Am Coll Cardiol.1991,17:442．
- [6] Johnson DE,Alderman EL.Schroeder JS,et al.Transplant coronary artery disease:Histopethologic correlations with angiographic morphology.J Am Coll Cardiol,1991,17:449．
- [7] Topol E. Promises and pitfalls of new devices for coronary artery diseasc.Circulation,1991,83:689～693．
- [8] Ischinger T.Coppenrathk, Weber H.et al.Laser Balioon Angioploplasty:Technical realization and vascular tissue effects of a modified concept.Laser in Surgery and Medicine,1990． 10:112．
- [9] Ischinger T. Fischer M.Riess G.et al.Verlauf und histologischer Be fund nach koronarer Stent Implantation wegen Rezidivstenosen nach PTCA: Ist die Therapie schlimmer als die Erkrankung? Z Kardiol,1990,79(Suppl 2) :124．
- [10] Forrester J, Fishbein M. Helfant R. et al. A Paradigm for Restenosis based on cell biology: Clues for the development of new preventive therapies. J Am Coll Cardiol,1991． 17:569～758．
- [11] Hollman J. Ischinger T. The problem of restenosis. In:Ischinger T. ed. Praetice of coronary angioplasty. Heidelberg: Springer Verlag,1986,211～222．
- [12] Noouyoshi M.Kimura T,Ohishi H,et al. Restenosis after percutaneous transluminal coronary angioplasty:Pathologic observations in 20 patients.J Am Coll cardiol.1991,17:433．
- [13] Plautz G,Nabel EG,Nabel GJ.Introduction of vascular smooth muscle cells expressing recombinant genes in vivo.Ciculation,1991,83:578．
- [14] Dartsch PC,Betz E,Ischinger T.Responses of cultured smooh muscle cells from human nonatherosclerotic arteries and primary stenosing lesions after photoirradiation:Implications for photodynamic therapy of vascular stenoses.J Am coll cadiol,1990,15:1545．
- [15] Dartsch PC,voisard R,Ischinger T,A comperison of dipyridamole and beta carotene with doxycycline for photodynamic reaction in vitro:results from human cell culture studies.Coronary artery disease,1990,1:251．
- [16] Dartsch PC,Isctheger,T,Betz E,Diffarential effect of photofrin II on growth of human smooth muscle cells from nonatherosclerotic arteries and atheromatous plaoues in vitro.Arteraselerosis,1990,10:616．
- [17] Dartsch PC,Betz E,Ischinger T.Wirkung von Dihamatoporphyrin-Derivaten auf kultivierte glatte Muskelzellen des Menschen aus normalen und atheroscle-rotisch verānderten Gefāssegmenten-Ubersicht ūber bisherige Ergebnisse und Implikationen fūr eine photodynamische Therapie.Z karaiol 1991,80:6．