Zusammenfassung
Die Koronarmorphologie prägt ganz entscheidend die Auswahlkriterien zur selektiven Therapie der Angina pectoris. Therapieziele sind die Verbesserung der Prognose bezüglich Überlebensrate und die Beschwerdefreiheit des Patienten. Ganz entscheidend ist die Frage, ob eine instabile AP vorliegt [5], oder in welchem Zusammenhang die Manifestation dieser koronarmorphologischen Veränderungen klinische Auswirkungen zeigte [6]. Das Syndrom der klinisch instabilen Angina pectoris führt zur Erwartungshaltung unregelmäßig begrenzter, unscharfer, schwer quantifizierbarer koronarmorphologischer Veränderungen. Im Falle der Bestätigung dieser Erwartungshaltung durch das koronar-morphologische Bild ist der Kliniker dann retrospektiv auch in seiner klinischen Entscheidung einer Instabilität des Krankheitsbildes bestätigt. Beide Kriterien, das klinische Erscheinungsbild und die morphologischen Befunde, bestimmen i.allg. die Vorgangsweise.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Ambrose JA, Winters SL, Arora RR et al. (1985) Coronary angiographic morphology in myocardial infarction: A link between the pathogenesis of unstable angina and myocardial infarction. J Am Coll Cardiol 6: 1233
Arora RR, Raymond RE, Dimas AP, Bhadwar K, Simpfendorfer C (1989) Side branch occlusion during coronary angioplasty: incidence, angiographic characteristics, and outcome. Cathet Cardiovasc Diagn 18: 210–212
Arora RR, Platko WP, Bhadwar K, Simpfendorfer C (1989) Role of intracoronary thrombus in acute complications during percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn 16: 226–229
Braunwald (1988) Heart disease, a textbook of cardiovascular medicine. Saunders, Philadelphia London Toronto Montreal Sydney Tokio
Bugiardini R, Pozzati A, Borghi A et al. (1991) Angiographic morphology in unstable angina and its relation to transient myocardial ischemia and hospital outcome. Am J Cardiol 67: 460–464
Ciampricotti R, El Gamal M, Relik T et al. (1990) Clinical characteristics and coronary angiographic dindings of patients with unstable angina, acute myocardial infarction, and survivors of sudden ischemic death ocurring during and after sport. Am Heart J 120: 1267–1278
Coy KM; Park C jr, Fishbein MC et al. (1992) In vitro validation of three-dimensional intravascular ultrasound for the evaluation of arterial injury after baloon angioplasty. J Am Cardiol 20: 692–700
Davies SW, Marchant B, Lyons JP et al. (1991) Irregular coronary lesion morphology after thrombolysis predicts early clinical instability. J Am Coll Cardiol 18: 669–674
Gould KL (1991) Coronary artery stenosis. Elsevier, New York Amsterdam London
Kereiakes DJ, Topol EJ et al. (1991) Myocardial infarction with minimal coronary atherosclerosis in the era of thrombolytic reperfusion. J Am Coll Cardiol 17: 304–312
Lendon CL, Davies MJ, Born GVR, Richardson PD (1991) Atherosclerotic plaque caps are locally weakened when macrophages density is increased. Atherosclerosis 87: 87–90
Leung W-H, Lau Chu-Pak (1992) Effects of severity of the residual stenosis of the infarct related coronary artery on left ventricular dilatation and function after acute myocardial infarction. J Am Coll Cardiol 20: 307–313
Lichtlen PR, Rafflenbeul W, Jost St, Hugenholtz P, Hecker H, Deckers J (1990) Verzögerung der angiographischen Progression der koronaren Herzkrankheit durch Nifedipin. Lancet 4/6
Lichtlen PR, Nikutta P, Jost St et al. (1992) Anatomical progression of coronary artery disease in humans as seen by prospective, repeated, quantitated coronary angiography. Relation to clinical events and risk factors. Circulation 86: 828–838
Mancini GBJ (1990) Digital coronary angiography in the evaluation of interventional techniques. In: Topol EJ (ed) Textbook of interventional cardiology. Saunders, Philadelphia
Mizuno K, Satomura K, Miyamoto A et al. (1992) Angioscopic evaluation of coronary artery thrombi in acute coronary syndromes. N Engl J Med 326: 287–291
O’Connor GT, Plume StK, Olmstead EM et al. (1992) Multivariate prediction of in hospital mortality associated with coronary artery bypass graft surgery. Circulation 85: 2110–2118
Popma JJ, Topol EJ, Dick RJ, Haudenschilld CC, Ellis SG (1991) Arterectomy of right coronary stenoses: Initial and long-term results, technical features, and histologic findings. Am J Cardiol 67: 431–433
Segal J, Lundgren CF (1992) Determination of the hemodynamic significance of coronary artery stenoses of intermediate severity. Am Heart J 124 4: 1073–1077
Taeymans Y, Théroux P, Lespérance J, Waters D (1992) Quantitative angiographic morphology of the coronary artery lesions at risk of thrombotic occlusion. Circulation 85: 78–85
Topol EJ (1990) Textbook of interventional cardiology. Saunders, Philadelphia London Toronto Montreal Sydney Tokio
Vassanelli C, Turri M, Morando G, Menegatti G, Zardini P (1989) Coronary arterial aneurysms after percutaneous transluminal coronary angioplasty — a not uncommon finding at elective follow-up angiography. Int J Cardiol 22: 151–156
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1995 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Mühlberger, V. (1995). Koronarmorphologie als Kriterium zur selektiven Therapie der Angina pectoris. In: Unger, F., Mörl, H., Dieterich, H.A. (eds) Interventionen am Herzen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-93558-9_4
Download citation
DOI: https://doi.org/10.1007/978-3-642-93558-9_4
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-93559-6
Online ISBN: 978-3-642-93558-9
eBook Packages: Springer Book Archive