摘要
近年来,我国的经皮冠状动脉介入治疗(PCI)规范化管理取得了很大进步。胸痛中心建设无疑是ST段抬高型心肌梗死的一种非常有效的救治模式。对非ST段抬高型急性冠状动脉综合征患者在入院时进行危险分层是合理应用介入策略和改善临床预后的前提。PCI已广泛用于高危患者(高龄、急性冠状动脉综合征、心力衰竭或内科合并症等)和各种复杂冠状动脉病变(左主干、冠状动脉慢性完全闭塞、严重钙化等)的治疗,并可达到与冠状动脉旁路移植术相同的临床疗效。冠状动脉内影像和功能学评估的应用,使更多的冠状动脉病变获得更精准的介入治疗。介入操作技能的改进和新技术的开展,以及术后抗血小板的正确使用,显著提高了特殊复杂病变PCI的成功率和远期疗效。本文对2022年PCI临床研究进展做一简要的回顾。
Currently, the standardized management of percutaneous coronary intervention(PCI) has been greatly improved in China. Establishment of chest pain center is undoubtly an extremely efficient mode of care for emergent patients with acute chest pain, especially those with ST-elevation myocardial infarction. Risk stratification at admission is an important prerequisite for optimal interventional treatment and better clinical outcome in patients with non-ST-elevation acute coronary syndrome. PCI has been utilized as a revascularization approach for high-risk patients(ie, very elderly, heart failure or comorbities) and complex coronary lesions(eg, left main disease, chronc total occlusion, severely calcified lesions), providing clinical benefits equivalent to those obtained by coronary artery bypass grafting. Extensive application of intracoronary imaging and functional assessment of coronary lesions is useful for precise decision-making in treating various coronary lesions particularly with intermediate stenosis. Likewise, the improvement of PCI techniques and use of novel interventional modalities increase the procedural success rate and clinical efficacy during complex PCI. This review will only give a glance at some of the clnical research progresses on PCI in the year of 2022.
作者
沈迎
王伟民
张奇
周玉杰
沈卫峰
SHEN Ying;WANG Wei-min;ZHANG Qi;ZHOU Yu-jie;SHEN Wei-feng(Department of Cardiovascular Medicine,Ruijin Hospital,Shanghai Jiaotong University Medical College,Shanghai 100025,China)
出处
《中国介入心脏病学杂志》
CSCD
2023年第1期25-32,共8页
Chinese Journal of Interventional Cardiology
