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25支，回旋支11支，左冠状动脉1支。与237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100.0%。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25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 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.
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