摘要(Abstract)：

<正> From 1992 to 1997,We perfomed PICA on 30 pts with corcoary beart dieeaselfaterial and methed:30 pts (26malea,4 females),aged 54(40-70)yrs,included 9post-infarction. 6 stable angina 15 unatable angina(course of diseaae lmonth12yrs cardiac function Ⅰ-Ⅱ°). The medical curative effects on them were poorAll were diagnosed as coraoary angiography.Tnere were 63 atenosis in 51 path-ologic lesions including 28 in LAD 9 in LCX 14in BCA 18 stenosis in 15 one-veoael cases,22 atenosis in 9 two-vesael caaos and 23 atenosis in 6 tbree-vessel cases.The atenosis degree was 75%-99% The medical curative effecta werepoor.Orumezig's technique was perfoned on them The pts were treated withaspirin(0.3g)po the day before operation hepr in(10000IU) iv when the leadingcatheter reached the right point,beprin(1000IU·h~(-1))ivgtt and nitroglycerin(5-10ug·min~(-1), 24h) ivgtt after operation Anticoagulant therapy kept for 3days then aspirin,persantina iaosorbide dinitrate po for 6-SmonthaResules:All pts had succassful PTCA Subjective aymptom was improved PTCA wassucceeaful in 44(86.3%) of 51 lesions, 54(85.7%) of 63 stenosis The guidewire(or the ballcon catheter) couldn't pass through the stenosis in 3LCX(ostial),2LAD(ostial)& 1 RCA(mid).Conclusion: The early indication of PTCA was one-Veasel(oatial) isolated.short, symmetrical and unclosed lesion,which had high rate of success andlittle Fiak In reacent yeara the indication included the complex lesions.The principle is to dilate the main lesion first,because the Vessel withaecondary lesion might be a functional one or a collateral circulation ofother coronary, The acute obliteration will lead to serious hemodynamicobstruction evem cardiogenic ahock or death Dilation by atagee is effectivein complicated lesions The rectenosis degree will decrease when we use theright htlloon in the loog tubular lesion The main reason for the failure isthat the guide wire or the balloon catheter can't pass the atenosis. When theguide wire can pass through the atenosis but the balloon can't,we shoulddilate the proximal part first then try to push the ballocm through theatencosis By this way,some serious lesions can be succesaful PTCA The maincomplication in PTCA is ventricular fibrillaton.because of the contrastmediun injected into the coronary artery.Sinus rhytlm can resume afterelectric defibrillation in time The aecond is acute obliteration because ofintimal laceration Balloom dilation with low preesure must be deployed, atfirst for a long time.The intima will bond togtber,and the vessel getsthrough Coronary Bypass mlat be perforned immediately if necessary.

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