急诊经皮冠状动脉介入治疗高血栓负荷病变的处理策略——延期支架置入
李永健
摘要(Abstract):
<正>一、概述当前各国的急性ST段抬高心肌梗死(STEMI)指南均将急诊支架置入术作为Ⅰ类证据、A类推荐[1-2]。然而,当我们回顾STEMI的急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)发展历程时会发现,在急诊PCI时代的早期,单纯经皮冠状动脉腔内血管成形术(percutaneous transluminal coronary angioplasty,PTCA)是急诊PCI的优选方案。随着噻吩并吡啶类药物在临床的广泛使用,使急性支
关键词(KeyWords):
基金项目(Foundation):
作者(Author): 李永健
参考文献(References):
- [1]Steg PG,James SK,Atar D,et al.ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.Eur Heart J,2012,33:2569-2619.
- [2]O'Gara PT,Kushner FG,Ascheim DD,et al.2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:executive summary:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.Circulation,2013,127:529-555.
- [3]Jolicoeur EM,Tanguay JF.From primary to secondary percutaneous coronary intervention:the emerging concept of early mechanical reperfusion with delayed facilitated stenting-when earlier may not be better.Can J Cardiol,2011,27:529-533.
- [4]Vlaar PJ,Svilaas T,van der Horst IC,et al.Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study(TAPAS):a 1-year follow-up study.Lancet,2008,371:1915-1920.
- [5]Henriques JP,Zijlstra F,Ottervanger JP,et al.Incidence and clinical significance of distal embolization during primary angioplasty for acute myocardial infarction.Eur Heart J,2002,23:1112-1117.
- [6]Wijns W,Kolh P,Danchin N,et al.Guidelines on myocardial revascularization.Eur Heart J,2010,31:2501-2555.
- [7]Levine GN,Bates ER,Blankenship JC,et al.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.Circulation,2011,124:e574-e651.
- [8]Cafri C,Svirsky R,Zelingher J,et al.Improved procedural results in coronary thrombosis are obtained with delayed percutaneous coronary interventions.J Invasive Cardiol,2004,16:69-71.
- [9]Isaaz K,Robin C,Cerisier A,et al.A new approach of primary angioplasty for ST-elevation acute myocardial infarction based on minimalist immediate mechanical intervention.Coron Artery Dis,2006,17:261-269.
- [10]Di Pasquale P,Cannizzaro S,Parrinello G,et al.Is delayed facilitated percutaneous coronary intervention better than immediate in reperfused myocardial infarction?Six months follow up findings.J Thromb Thrombolysis,2006,21:147-157.
- [11]Meneveau N,Séronde MF,Descotes-Genon V,et al.Immediate versus delayed angioplasty in infarct-related arteries with TIMIⅢflow and ST segment recovery:a matched comparison in acute myocardial infarction patients.Clin Res Cardiol,2009,98:257-264.
- [12]Tang L,Zhou SH,Hu XQ,et al.Effect of delayed vs immediate stent implantation on myocardial perfusion and cardiac function in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous intervention with thrombus aspiration.Can J Cardiol,2011,27:541-547.
- [13]Berry C.DEFER STEMI:A randomised trial of deferred vs.immediate stenting to prevent no-reflow in acute STEMI.Presented at:American College of Cardiology Annual Scientific Session,March 9,2013;San Francisco,CA.