20xx年醫(yī)學(xué)專題—對多支血管的冠心病選擇經(jīng)皮血管成形術(shù)或者外科手術(shù)的血管成形術(shù)(存儲版)
【正文】 P12948331,Stent Thrombosis,Symptomatic Graft Occlusion,T Feldman EuroPCR 2009,第三十頁，共三十八頁。,第三十七頁，共三十八頁。Double LIMA/RIMA 27.6 (236/854) 16.1 (104/644),第三十八頁，共三十八頁。,Explore The Best Of Both Worlds?,Hybrid approaches to minimize morbidity, recovery, pain and maximize durability Robotic IMA to LAD PCI with DES to nonLAD disease,第三十五頁，共三十八頁。41.2 mean 177。,Procedural Differences Between SYNTAX PCI Randomized Cohort and the PCI Registry,PCI RCT PCI registry Variable n=903 n=192 Complete revasc (%) 56.7 (508/896) 36.5 (70/192) Lesions, no. (mean 177。,第二十二頁，共三十八頁。,SYNTAX CABG/PCI Registries,SYNTAX appendix: NEJM, 2009,Reasons for CABG,Complex anatomy 70.9% Untreatable chronic 22.0% total occlusion Unable to take 0.9% antiplatelet medications Patient refused PCI 0.5% Other 5.7%,Reasons for PCI,Comorbidity 70.7% No graft material 9.1% Patient refused CABG 5.6% Small or poor quality 1.5% of distal vessel Other 13.1%,n=644,n=192,第十六頁，共三十八頁。,Increased Likelihood of Restenosis Lesion/Patient Subsets,Small vessels Bifurcations Ostial CTO Bare metal ISR SVG AMI (thrombus) Diabetes mellitus,第九頁，共三十八頁。Percutaneous or Surgical Revascularization for Multivessel Coronary Artery Disease?,Verghese Mathew, MD, FACC Consultant, Division of Cardiovascular Diseases and Department of Radiology Professor of Medicine, Mayo Clinic College of Medicine,第一頁，共三十八頁。,CABG vs Stenting for MVD MetaAnalysis of ARTS, ERACIII, MASSII and SOS,Circ 118, 2008,Days,EventFree Survival Analysis of Death,1,518 1,472 1,456 1,440 1,406 1,347 1,533 1,479 1,457 1,439 1,412 1,349,Overall survival (%),P=0.78,Days,Repeat Revascularization,1,518 1,204 772 740 707 665 1,533 1,428 927 911 882 855,P0.0001,Overall survival (%),Days,Death, Str
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