冠心病不同治療方法的選擇(編輯修改稿)
2025-06-22 03:34 本頁(yè)面
【文章內(nèi)容簡(jiǎn)介】 all pts received ASA, bblocker, dalteparin invasive conserv. cath 98% 48% PCI 44% 18% CABG 34% 19% Fast Revascularization During Instability in Coronary Artery Disease Wallentin L, 1999 ACC Scientific Sessions。 JACC 34:14, 1999 FRISC II 6 Month Death / MI 9 . 5 %9 . 8 %9 . 2 %1 2 . 0 %1 2 . 7 %1 1 . 5 %0%3%6%9%12%15%a l l p l a c e b o d a l t e p a r i nx 3 m o n t hi n v a si v en o n i n v a si v eWallentin L, 1999 ACC Scientific Sessions。 JACC 34:14, 1999 p= TACTICS TIMI 18 ?2,200 patients with ACS ?randomization: invasive vs. noninvasive rx ?invasive strategy: cath + revasc within 448 hr ?noninvasive strategy: cath for +ETT, refractory / severe ischemia, MI ?all pts received ASA, bblocker, Aggrastat Cannon C, 2022 AHA Scientific Sessions。 Late Breaking Clinical Trials TACTICS TIMI 18 6 Month Outes 9 . 5 %6 . 5 %1 2 . 5 %9 . 3 %0%3%6%9%12%15%p r i m a r y e n d p t d e a t h + M Ii n v a si v en o n i n v a si v eCannon C, 2022 AHA Scientific Sessions。 Late Breaking Clinical Trials p= p= CABG術(shù)后心肌缺血復(fù)發(fā) ? LIMA10年通暢率 90%以上， SVG最初幾年每年 10%病變發(fā)生率， 10年通常率 4050% ?自身血管新病變 ?處理：再次 CABG可能性小，死亡率高，介入 治療成為最佳選擇 Stenting for degenerated SVG stenosis with distal protection device Medtronic GuardWireTM plus Male, 68yrs, CABG Oct. 1994, 心絞痛復(fù)發(fā) Jul. 2022 Stenting for distal anastomosis stenosis of LIMALAD 2w postMIDCAB Male, 56yrs, MIDCAB（ LIMALAD） 2022, 2周后 AP復(fù)發(fā) Stenting for distal anastomosis stenosis of LIMALAD 2w postMIDCAB LAO RAO Stenting for distal anastomosis stenosis of LIMALAD 2w postMIDCAB 球囊擴(kuò)張后 支架植入后 Intervention 2022 From 全國(guó)逐年 PTCA例數(shù)增長(zhǎng)情況 0500010000150002022025000198487198819891990199119921993199419951996199719981999200020012
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