医学
再狭窄
心绞痛
新生内膜增生
心脏病学
血管成形术
冠状动脉疾病
血液透析
支架
介入心脏病学
内科学
管腔(解剖学)
外科
心肌梗塞
作者
Carol Brown,Leslie Clark,Lori Williams,Susan Gallagher,Michele Levesque,Judy Silva
出处
期刊:Journal of The American Academy of Nurse Practitioners
[Wiley]
日期:1996-06-01
卷期号:8 (6): 283-283
被引量:1
标识
DOI:10.1111/j.1745-7599.1996.tb00661.x
摘要
Return of angina within 6 months of a catheter-based treatment of coronary artery disease usually reflects restenosis due to an overly aggressive local healing response to the procedure-related arterial injury. The restenotic lesion should be treated aggressively. Patients with preexisting diabetes mellitus, renal failure requiring hemodialysis, and left anterior descending artery lesions should be considered to be at exceedingly high risk for clinically significant restenosis. Exercise testing is indicated for all patients who experience a return of their angina within 6 months of an interventional procedure. Nurse practitioners in the primary care setting may be the first clinicians to hear of the return of angina. Patients should always be reassured that repeat intervention is almost always possible and is generally effective in providing long-term relief. New devices (in particular the Palmaz-Schatz stent) may help reduce the likelihood of restenosis, to the extent that they provide a large acute post-treatment lumen diameter that is more tolerant of intimal hyperplasia without producing significant narrowing. Until adjunctive drug therapy is found that effectively reduces the local tissue response to interventional therapy, all clinicians involved in caring for patients following such procedures will need to be vigilant and knowledgeable about recognizing and treating restenosis.
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