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)-資料下載頁
2024-11-09 04:13本頁面
【正文】 ion for Multivessel Coronary Artery Disease?,Spectrum of risk (anatomic, clinical) in patients with stable multivessel CAD Patients with more extensive, diffuse CAD (higher SYNTAX score) fare better with CABG than PCI due to repeat revascularization rates Lower SYNTAX score patients do well with PCI There are some patients too high risk for CABG,第三十一頁，共三十八頁。,Limitations of PCI,TLR remains higher with PCI than CABG Long segments of stents Postdilation, IVUS Dual antiplatelet therapy Stent thrombosis PCI still has a significant acute failure rate in specific lesion subsets: CTO Bifurcation SVG Severe calcification/tortuosity,第三十二頁，共三十八頁。,Limitations of CABG,Longterm graft attrition。 total arterial revascularization still uncommon Native vessel progression CABG not curative PCI frequently utilized for symptom relief in postCABG,第三十三頁，共三十八頁。,Selection of Revascularization Modality What Should We Emphasize Moving Forward?,Careful assessment of anatomic and clinical risk Meticulous stent deployment techniques Prolonged dual antiplatelet therapy for DES Bioabsorbable stents Device/equipment development to contend with lesion subsets in which PCI fails Optimize adjuvant medical therapy (antiplatelet, statin, ACEI) particularly in post CABG patients Total arterial revascularization,第三十四頁，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。,第三十六頁，共三十八頁。,第三十七頁，共三十八頁。,內(nèi)容(n232。ir243。ng)總結(jié),Percutaneous or Surgical Revascularization for Multivessel Coronary Artery Disease。0.01 0.1 1 10 100。Complete revasc (%) 63.2 (550/870) 74.7 (481/644)。Double LIMA/RIMA 27.6 (236/854) 16.1 (104/644),第三十八頁，共三十八頁
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