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Kokyu to Junkan Volume 34, Issue 12 （December 1986）

呼吸と循環 34巻12号（1986年12月発行）

Japanese English

研究

PTCAにおけるside branch occlusionおよびstenosisについて Side branch occlusion and stenosis during percutaneous transluminal coronary angioplasty 坂田和之 ¹ , 星野恒雄 ¹ , 横山正一 ¹ , 高山真一 ¹ , 森典子 ¹ , 吉田裕 ¹ , 岩瀬知行 ¹ , 新宮哲司 ¹ , 鏑木恒男 ¹ Kazuyuki Sakata ¹ , Tsuneo Hoshino ¹ , Shoichi Yokoyama ¹ , Shin-ichi Takayama ¹ , Noriko Mori ¹ , Hiroshi Yoshida ¹ , Tomoyuki Iwase ¹ , Tetuji Shingu ¹ , Tsuneo Kaburagi ¹ ¹静岡県立総合病院循環器科 ¹Department of Cardiology, Shizuoka General Hospital pp.1335-1341

発行日 1986年12月15日 Published Date 1986/12/15

DOI https://doi.org/10.11477/mf.1404204979

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Abstract 文献概要
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　1977年，Grüntzig^1）らによって始められたPTCA（percutaneous transluminal coronary angioplasty）は，狭心症^2〜5）および心筋梗塞^6〜8）に対してその有効性が高く評価されている反面，多くの合併症を生ずる危険性がある。

　side branch injury （SBI）（side branchの閉塞および狭窄）は，PTCAの合併症の1つであるが，その予後は比較的良好と考えられている。しかし，大きなside bra—nchの場合は心筋梗塞や狭心症を発生させる危険性があり充分な注意が必要である。

To assess the incidence and significance of side branch injury (SBI) including side branch occlusion and stenosis during percutaneous transluminal coronary angioplasty (PTCA), 44 coronary arteries with 83 side branches were analyzed from 39 patients treated by PTCA. We investigated the relationship between SBI and several factors; branching portion of the side branch, balloon diameter and pressure, and anatomical characteristics of the target lesion.

SBI occurred in 16 (19%) of 83 side brancheo following PTCA (7 occlusion, 9 stenosis). SBI occurred in 14 of 35 side branches originating from the target lesion and in 2 of 48 side branches originating from the vicinity of it. The incidence of SBI was significantly higher in the former than in the latter (p<0.01). The target lesion with SBI tended to be diffuse and eccentric and to have tortuosity and calcification. In addition, the target lesion with SBI was considered to be tight because luminal enlargement of target lesion with SBI was smaller than that without SBI (p< 0. 01). There was no significant relationship bet-ween SBI and balloon diameter and pressure. No patients with side branch stenosis had an elevation of CPK and ECG changes after PTCA. Two of 4 patients with angina pectoris, who had side branch occlusion, had myocardial infarction after PTCA. We must be cautious of the target lesion with side branch during PTCA.