冠心病复杂冠脉病变研究进展
Research Progress of Complex Coronary Artery Disease in Coronary Heart Disease
DOI: 10.12677/acm.2024.1482350, PDF,   
作者: 白 喆：延安大学附属医院心内科，陕西 延安
关键词: 冠心病；冠脉复杂病变；OCT；IVUS；FFR；Coronary Heart Disease； Complex Coronary Artery Disease； OCT； IVUS； FFR
摘要: 复杂冠脉病变是冠心病中的一大挑战，其多样的病变形式和复杂的解剖特征增加了诊断和治疗的难度。近年来，随着医疗技术的突飞猛进，新器械及新技术的出现为这类患者诊疗提供了更多保障。在复杂冠脉病变的治疗中，腔内影像学与功能学评估是建立在冠脉造影基础上的可靠技术，能够弥补冠脉造影的不足，为术者提供更为准确和全面的信息。这些先进评估技术有助于指导血运重建策略的制定，减少不良心血管事件的发生，从而改善患者的预后。
Abstract: Complex coronary artery disease is a major challenge in coronary heart disease. Its diverse forms of lesions and complex anatomical features increase the difficulty of diagnosis and treatment. In recent years, with the rapid development of medical technology, the emergence of new instruments and new technologies has provided more guarantees for the diagnosis and treatment of such patients. In the treatment of complex coronary artery disease, endovascular imaging and functional evaluation is a reliable technique based on coronary angiography, which can make up for the deficiency of coronary angiography and provide more accurate and comprehensive information for the surgeon. These advanced evaluation techniques can help guide the formulation of revascularization strategies, reduce the occurrence of adverse cardiovascular events, and improve the prognosis of patients.
文章引用：白喆. 冠心病复杂冠脉病变研究进展[J]. 临床医学进展, 2024, 14(8): 1277-1281. https://doi.org/10.12677/acm.2024.1482350

参考文献

[1] 葛均波, 徐永健, 王辰. 内科学[M]. 第9版. 北京: 人民卫生出版社, 2018: 150-261+725-786.
[2] Levine, G.N., Bates, E.R., Blankenship, J.C., et al. (2011) 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Journal of the American College of Cardiology, 58, e44-e122.
[3] Lee, J.M., Choi, K.H., Song, Y.B., Lee, J., Lee, S., Lee, S.Y., et al. (2023) Intravascular Imaging-Guided or Angiography-Guided Complex PCI. New England Journal of Medicine, 388, 1668-1679. [Google Scholar] [CrossRef] [PubMed]
[4] Henriques, J.P.S., Claessen, B.E., Dangas, G.D., Kirtane, A.J., Popma, J.J., Massaro, J.M., et al. (2015) Performance of Currently Available Risk Models in a Cohort of Mechanically Supported High-Risk Percutaneous Coronary Intervention—From the PROTECT II Randomized Trial. International Journal of Cardiology, 189, 272-278. [Google Scholar] [CrossRef] [PubMed]
[5] Shan, L., Ge, W., Pu, Y., Cheng, H., Cang, Z., Zhang, X., et al. (2018) Assessment of Three Risk Evaluation Systems for Patients Aged ≥70 in East China: Performance of Sinoscore, Euroscore II and the STS Risk Evaluation System. Peer J, 6, e4413. [Google Scholar] [CrossRef] [PubMed]
[6] Patel, M.R., Calhoon, J.H., Dehmer, G.J., et al. (2017) ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT. Journal of the American College of Cardiology, 69, 2212-2241.
[7] Banning, A.P., Serruys, P., De Maria, G.L., Ryan, N., Walsh, S., Gonzalo, N., et al. (2021) Five-Year Outcomes after State-of-the-Art Percutaneous Coronary Revascularization in Patients with de Novo Three-Vessel Disease: Final Results of the SYNTAX II Study. European Heart Journal, 43, 1307-1316. [Google Scholar] [CrossRef] [PubMed]
[8] Koskinas, K.C., Ughi, G.J., Windecker, S., Tearney, G.J. and Räber, L. (2015) Intracoronary Imaging of Coronary Atherosclerosis: Validation for Diagnosis, Prognosis and Treatment. European Heart Journal, 37, 524-535. [Google Scholar] [CrossRef] [PubMed]
[9] Shimamura, K. and Guagliumi, G. (2016) Optical Coherence Tomography for Online Guidance of Complex Coronary Interventions. Circulation Journal, 80, 2063-2072. [Google Scholar] [CrossRef] [PubMed]
[10] Araki, M., Park, S., Dauerman, H.L., Uemura, S., Kim, J., Di Mario, C., et al. (2022) Optical Coherence Tomography in Coronary Atherosclerosis Assessment and Intervention. Nature Reviews Cardiology, 19, 684-703. [Google Scholar] [CrossRef] [PubMed]
[11] Kala, P., Cervinka, P., Jakl, M., Kanovsky, J., Kupec, A., Spacek, R., et al. (2018) OCT Guidance during Stent Implantation in Primary PCI: A Randomized Multicenter Study with Nine Months of Optical Coherence Tomography Follow-Up. International Journal of Cardiology, 250, 98-103. [Google Scholar] [CrossRef] [PubMed]
[12] Prati, F., Romagnoli, E., Burzotta, F., Limbruno, U., Gatto, L., La Manna, A., et al. (2015) Clinical Impact of OCT Findings during PCI. JACC: Cardiovascular Imaging, 8, 1297-1305. [Google Scholar] [CrossRef] [PubMed]
[13] 赵祖亮, 杨承健, 叶新和. 光学相干断层扫描在冠状动脉粥样硬化性心脏病介入中的应用[J]. 国际心血管病杂志, 2020, 47(4): 225-229.
[14] Bangalore, S. and Bhatt, D.L. (2013) Coronary Intravascular Ultrasound. Circulation, 127, e868-e874. [Google Scholar] [CrossRef] [PubMed]
[15] Mintz, G.S., Garcia-Garcia, H.M., Nicholls, S.J., et al. (2011) Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Regression/Progression Studies. EuroIntervention, 6, 1123-1130.
[16] Hannan, E.L., Zhong, Y., Reddy, P., Jacobs, A.K., Ling, F.S.K., King III, S.B., et al. (2022) Percutaneous Coronary Intervention with and without Intravascular Ultrasound for Patients with Complex Lesions: Utilization, Mortality, and Target Vessel Revascularization. Circulation: Cardiovascular Interventions, 15, e011687. [Google Scholar] [CrossRef] [PubMed]
[17] Chamié, D., Costa, J.R., Damiani, L.P., Siqueira, D., Braga, S., Costa, R., et al. (2021) Optical Coherence Tomography versus Intravascular Ultrasound and Angiography to Guide Percutaneous Coronary Interventions: The iSIGHT Randomized Trial. Circulation: Cardiovascular Interventions, 14, e009452. [Google Scholar] [CrossRef] [PubMed]
[18] Kang, D., Ahn, J., Yun, S., Hur, S., Cho, Y., Lee, C.H., et al. (2024) Guiding Intervention for Complex Coronary Lesions by Optical Coherence Tomography or Intravascular Ultrasound. Journal of the American College of Cardiology, 83, 401-413. [Google Scholar] [CrossRef] [PubMed]
[19] 马贵洲, 徐荣和, 蔡志雄, 等. 复杂高危冠脉病变患者介入治疗现状及进展[J]. 实用医学杂志, 2021, 37(24): 3107-3112.
[20] Writing Committee Members, Lawton, J.S., Tamis-Holland, J.E., et al. (2022) 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 79, e21-e129.
[21] Hu, P., Tang, M., Song, W., Jiang, J., Sun, Y., Liu, X., et al. (2015) Fractional Flow Reserve Guided Percutaneous Coronary Intervention Improves Clinical Outcome with Reduced Cost in Contemporary Clinical Practice. Chinese Medical Journal, 128, 2000-2005. [Google Scholar] [CrossRef] [PubMed]
[22] 王建安, 郭丽君, 张永珍, 等. 冠状动脉血流储备分数临床应用专家共识[J]. 中华心血管病杂志, 2016, 44(4): 292-297.
[23] 霍勇, 郑博, 刘耀琨. 冠心病介入诊疗最新临床研究进展[J]. 临床心血管病杂志, 2023, 39(5): 327-331.
[24] Jurado-Román, A., Gómez-Menchero, A., Amat-Santos, I.J., Caballero-Borrego, J., Ojeda, S., Ocaranza-Sánchez, R., et al. (2024) Design of the ROLLERCOASTR Trial: Rotational Atherectomy, Lithotripsy or Laser for the Management of Calcified Coronary Stenosis. REC: Interventional Cardiology, 5, 279-286. [Google Scholar] [CrossRef] 
[25] Moreno, P.R., Stone, G.W., Gonzalez-Lengua, C.A. and Puskas, J.D. (2020) The Hybrid Coronary Approach for Optimal Revascularization. Journal of the American College of Cardiology, 76, 321-333. [Google Scholar] [CrossRef] [PubMed]

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