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percutaneous coronary interventions pci
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     Clinical application of percutaneous coronary intervention.
     经皮动脉闭合术的临床应用
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     Value of Statin in Percutaneous Coronary Intervention
     他汀类药物在冠状动脉介入中应用的价值
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     Percutaneous Transluminal Coronary Angioplasty (PTCA)
     冠状动脉成形术(附3例报导)
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     Percutaneous coronary interventions in geriatric patients
     老年冠心病的介入治疗
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     Analyse of Complication of PCI (Percutaneous coronary intervention)
     经皮冠状动脉介入治疗并发症分析
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  percutaneous coronary interventions pci
Glycoprotein (GP) IIb/IIIa inhibitors reduce major adverse coronary events in patients with acute coronary syndromes undergoing percutaneous coronary interventions (PCI).
      
Glycoprotein (GP) IIb/IIIa inhibitors have been shown to reduce morbidity and mortality in patients with acute coronary syndromes undergoing percutaneous coronary interventions (PCI).
      
One approach is the resurgent use of facilitated percutaneous coronary interventions (PCI).
      
The initial studies of hirudin and bivalirudin in the clinical settings of acute myocardial infarction (AMI), unstable angina (UA) and percutaneous coronary interventions (PCI) conducted in the early 1990s proved to be disappointing.
      
Background: Previous studies have demonstrated a prolongation of activated clotting times (ACT) with abciximab administration during percutaneous coronary interventions (PCI).
      
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Objective To evaluate the safety and efficiency of percutaneous coronary interventions(PCI) in octogenarian Chinese with coronary artery disease. Methods A total of 43 patients aged over 80 years old underwent 45 such procedures at Queen Mary Hospital from October 1994 to May 1998. There were 27 male and 16 female 〔 mean age (82.3±2.5), range (80 89)〕. 55.8% of these patients had multi vessel lesions. A total of 48 lesions in 43 patients was treated 〔25 LAD(52 1%), 11 LCX(22...

Objective To evaluate the safety and efficiency of percutaneous coronary interventions(PCI) in octogenarian Chinese with coronary artery disease. Methods A total of 43 patients aged over 80 years old underwent 45 such procedures at Queen Mary Hospital from October 1994 to May 1998. There were 27 male and 16 female 〔 mean age (82.3±2.5), range (80 89)〕. 55.8% of these patients had multi vessel lesions. A total of 48 lesions in 43 patients was treated 〔25 LAD(52 1%), 11 LCX(22 9%) , 11 RCA(22 9%), 1 LM (2 1%)〕. Results Thirty seven (86.1%) patients were successfully performed PCI. Sixteen of them deployed stenting. Among the 6 lesions which failed to cross, 5 of lesions were LAD, 3 of them were total occlusion. The success rate and complication during the procedure were not significant difference compared with the control in 237 patients <80 years of age. At 18 months follow up, 78.5% of these patients was free or much improved of chest pain. The restenosis rate was 36.0% confirmed by coronary angiogram performed in 25 patients. Conclusions In octogenarians with coronary artery disease PCI was a safe and effective procedure with a high successful rate, low acceptable complication rate and a favorable immediate and long term outcomes.

目的 观察 80岁以上冠心病患者接受经皮冠状动脉 (冠脉 )腔内介入治疗术 (PCI)的安全性和有效性。 方法 对 43例≥ 80岁的冠心病患者的 48支相关血管进行PCI 45次 ,其中右主干11支 ,左前降支 2 5支 ,回旋支 11支 ,左冠状动脉 1支。与 2 37例 <80岁行PCI的冠心病患者进行比较。 结果  37例患者手术成功 ,手术成功率 86 1% ,再通 42支病变血管 (87 5 % ) ,置入冠脉内支架16枚 ,成功率 10 0 0 %。 6支血管再通失败 ,其中 5支左前降支 (LAD) ,手术相关并发症 2例 ,均为LAD近端闭塞扩张后再闭塞或引起左主干 (LM)夹层 ,其中 1例术后 1周死于室性心动过速。随访 37例 ,平均随访时间 (18 0± 8 8)个月。手术后 6~ 12个月行冠脉造影随访 2 5例 ,再狭窄率 36 0 %。 结论 对 80岁以上冠心病患者行PCI治疗是安全有效的 ,成功率较高 ,并发症少 ,但应严格掌握手术适应证。

Objective:To study the clinical efficacy of immediate percutaneous transluminal coronary angioplasty (PTCA) and primary intracoronary stenting after intravenous thrombolytic therapy using recombinant tissue plasminogen activator (rt PA) in patients with acute myocardial infarction (AMI).Method:From January 1998 to July 2001, one hundred and forty consecutive patients with AMI were divided into two groups. In group A, 75 patients received intravenous thrombolytic...

Objective:To study the clinical efficacy of immediate percutaneous transluminal coronary angioplasty (PTCA) and primary intracoronary stenting after intravenous thrombolytic therapy using recombinant tissue plasminogen activator (rt PA) in patients with acute myocardial infarction (AMI).Method:From January 1998 to July 2001, one hundred and forty consecutive patients with AMI were divided into two groups. In group A, 75 patients received intravenous thrombolytic therapy using rt PA 50 mg before they had coronary aniography (CAG), PTCA and primary intracoronary stenting. In group B, 65 cases only received CAG, PTCA and primary intracoronary stenting. Left ventricular ejection was measured by two dimensional echocardiography and cardiac events were recorded during follow up.Result:①The first CAG when patients received cardiac catheterization showed that the re open rate of infarct related artery (IRA) in group A was 52% , while that in group B was 15%. The difference between group A and group B was significant (P< 0.01 ).②The re open rate of IRA in operated PTCA and stenting in group A and B was similar ( group A 100%; group B 98.6 % ). ③ At 20 days follow up, the left ventricular ejection fraction reached or exceeded 60% in group A was 95%, while that in group B was 44%. The difference between group A and group B was significant (P< 0.05 ). ④No complications of cerebral hemorrhage and hemorrhage were found in group A and group B .⑤ The mortality in hospital in group A was 4%, While that in group B was 3% , The difference between group A and group B was insignificant (P> 0.05 ).Conclusion:Comparison of the clinical curative effect between previous intravenous rt PA plus percutaneous coronary intervention (PCI) and PCI alone in AMI shows that the former method can reopen IRA earlier, decrease the complication in the operation of intracoronary stenting, protects the left ventricular ejection fraction more effectively and does not increase heart events happening.

目的 :比较rt PA(5 0mg)静脉溶栓后即刻行经皮腔内冠状动脉成形术 (PTCA)与直接冠状动脉支架术治疗急性心肌梗死 (AMI)的临床疗效。方法 14 0例AMI患者 ,随机分为A、B两组。A组 75例行rt PA半量 (5 0mg)静脉溶栓后即刻行冠状动脉造影 (CAG)、PTCA及冠状动脉支架术。B组 6 5例直接行CAG、PTCA及冠状动脉支架术。术后观察 2 0d。结果 :①首次冠状动脉造影显示 :A组梗死相关动脉 (IRA) 83支 ,开通率 5 2 % ;B组IRA 71支 ,开通率 15 %。两组开通率相比差异有非常显著性意义 (P <0 .0 1)。②A、B两组行PTCA加支架置入术后IRA恢复TIMIⅢ级血流效果基本相同 ,A组 10 0 % ,B组 98.6 % ,两者相比差异无显著性意义 (P >0 .0 5 )。③患者住院 10~ 2 0d ,二维超声心动图显示 ,左室射血分数达到或超过 6 0 %者 ,A组为 94 .7% ,而B组仅占 4 3.9%。两者相比差异有显著性意义 (P <0 .0 5 )。④脑卒中或大出血并发症两组病例均未发生。⑤住院病死率 ,A组 4 .0 %...

目的 :比较rt PA(5 0mg)静脉溶栓后即刻行经皮腔内冠状动脉成形术 (PTCA)与直接冠状动脉支架术治疗急性心肌梗死 (AMI)的临床疗效。方法 14 0例AMI患者 ,随机分为A、B两组。A组 75例行rt PA半量 (5 0mg)静脉溶栓后即刻行冠状动脉造影 (CAG)、PTCA及冠状动脉支架术。B组 6 5例直接行CAG、PTCA及冠状动脉支架术。术后观察 2 0d。结果 :①首次冠状动脉造影显示 :A组梗死相关动脉 (IRA) 83支 ,开通率 5 2 % ;B组IRA 71支 ,开通率 15 %。两组开通率相比差异有非常显著性意义 (P <0 .0 1)。②A、B两组行PTCA加支架置入术后IRA恢复TIMIⅢ级血流效果基本相同 ,A组 10 0 % ,B组 98.6 % ,两者相比差异无显著性意义 (P >0 .0 5 )。③患者住院 10~ 2 0d ,二维超声心动图显示 ,左室射血分数达到或超过 6 0 %者 ,A组为 94 .7% ,而B组仅占 4 3.9%。两者相比差异有显著性意义 (P <0 .0 5 )。④脑卒中或大出血并发症两组病例均未发生。⑤住院病死率 ,A组 4 .0 % (3/ 75 ) ,B组 3.1% (2 / 6 5 ) ,两者相比差异无显著性意义 (P >0 .0 5 )。结论 :A组较B组具有更早地使IRA前向血流再灌注 ,从而具有较好的左室保护功能 ,且不增加不良事件的发生。

Objective: To discuss the risk factors related to the "no reflow" phenomenon after reperfusion therapy for patients with acute myocardial infarction (AMI). Methods: Thirty two patients with first anterior AMI underwent successfully percutaneous coronary intervention (PCI), including primary percutaneous transluminal coronary angioplasty and stent implantation. TIMI 3 flow of infarction related artery (IRA) was obtained. Intravenous myocardial contrast echocardiography...

Objective: To discuss the risk factors related to the "no reflow" phenomenon after reperfusion therapy for patients with acute myocardial infarction (AMI). Methods: Thirty two patients with first anterior AMI underwent successfully percutaneous coronary intervention (PCI), including primary percutaneous transluminal coronary angioplasty and stent implantation. TIMI 3 flow of infarction related artery (IRA) was obtained. Intravenous myocardial contrast echocardiography (MCE) was performed within 12 hours after PCI. Multivariate analysis was used to identify risk factors related to the "no reflow" phenomenon. Results: MCE revealed the "no reflow" phenomenon in 11 patients .Univariate analysis demonstrated that absence of pre infarction angina, Killip class, total occlusion of IRA, number of abnormal Q waves, resolution of the sum of ST segment index (∑STI) less than 50 percent of pre PCI and re elevation of ∑STI more than or equal 30 percent of pre PCI at 20 minutes after IRA revascularization and wall motion score (WMS) were significantly related to the development of the "no reflow" phenomenon ( p <0 05). Multivariate analysis indicated that all of the above factors, except for Killip class, were independent risk factors of the "no reflow" phenomenon, and the number of abnormal Q waves was the risk factor strongly related to the phenomenon. Conclusion: After successful reperfusion therapy about 1/3 patients present with "no reflow" phenomenon. Development of this phenomenon is significantly related to the size of risk area, or WMS, the myocardial damage severity, or number of abnormal Q waves, the re elevation of ∑STI, the IRA total occlusion and absence of pre infarction angina.

目的 :阐明与急性心肌梗死成功再灌注后无再流现象发生相关的临床危险因素。方法 :3 2例前壁急性心肌梗死患者在症状出现后 2 4h内成功施行经皮冠状动脉腔内成形术和支架置入术使梗死相关动脉均达到心肌梗死溶栓治疗临床试验 (TIMI) 3级血流 ,术后 12h内进行静脉心肌声学造影 (MCE) ,应用多变量分析确定无再流现象的独立危险因素。结果 :3 2例患者根据术后 12hMCE积分显示无再流者 11例 ,再流者 2 1例。单变量分析表明急性心肌梗死症状发作前 48h内无心肌梗死前心绞痛、心功能Killip分级、梗死相关动脉完全闭塞、异常Q波数、梗死相关动脉成功再通后2 0min相关导联ST段抬高指数 (∑STI)下降 <5 0 %和∑STI再抬高≥ 3 0 %及超声心动图上室壁运动积分与无再流现象明显相关 (P <0 0 5 ) ;多变量分析发现上述因素中除心功能Killip分级 ,其它均是无再流现象发生的独立危险因素 ,其中异常Q波数与无再流现象发生相关性最好 (R2 =0 896,P =0 0 0 0 4)。结论 :急性心肌梗死成功再灌注后约 1/3患者静脉MCE时表现为无再流现象 ,无再流现象与...

目的 :阐明与急性心肌梗死成功再灌注后无再流现象发生相关的临床危险因素。方法 :3 2例前壁急性心肌梗死患者在症状出现后 2 4h内成功施行经皮冠状动脉腔内成形术和支架置入术使梗死相关动脉均达到心肌梗死溶栓治疗临床试验 (TIMI) 3级血流 ,术后 12h内进行静脉心肌声学造影 (MCE) ,应用多变量分析确定无再流现象的独立危险因素。结果 :3 2例患者根据术后 12hMCE积分显示无再流者 11例 ,再流者 2 1例。单变量分析表明急性心肌梗死症状发作前 48h内无心肌梗死前心绞痛、心功能Killip分级、梗死相关动脉完全闭塞、异常Q波数、梗死相关动脉成功再通后2 0min相关导联ST段抬高指数 (∑STI)下降 <5 0 %和∑STI再抬高≥ 3 0 %及超声心动图上室壁运动积分与无再流现象明显相关 (P <0 0 5 ) ;多变量分析发现上述因素中除心功能Killip分级 ,其它均是无再流现象发生的独立危险因素 ,其中异常Q波数与无再流现象发生相关性最好 (R2 =0 896,P =0 0 0 0 4)。结论 :急性心肌梗死成功再灌注后约 1/3患者静脉MCE时表现为无再流现象 ,无再流现象与心肌损害的严重性 (异常Q波数 )、危险区的大小 (室壁运动积分 )、梗死相关动脉完全闭塞、∑STI再抬高和无心肌梗死前心绞痛等因素显著相关。

 
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