王伟民,霍勇,葛均波

• 1:北京大学人民医院
• 2:北京大学第一医院
• 3:复旦大学附属中山医院

摘要(Abstract)：

<正>随着经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的不断发展,介入治疗更多涉及到更为复杂的病变,而冠状动脉钙化病变经常贯穿于各种复杂病变,增加了冠状动脉介入治疗的难度,是心血管介入医师所面临的主要挑战之一,尤其是严重钙化病变,或伴有扭曲、成角、弥漫的严重钙化病变,手术即刻的并发症以及早期和晚期主要不良心血管事件的发生率明显升高。正确地识别、评估钙化病变,选择恰当的介入治疗技术,对于提高手术成功率、减少手术相关并发症、改善患者近、远期预后都非常重要。

关键词(KeyWords)： 冠状动脉钙化病变;经皮冠状动脉介入治疗;专家共识

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王伟民,霍勇,葛均波

参考文献(References)：

• [1]Alexopoulos N,Raggi P.Calcifi cation in atherosclerosis.Nat Rev Cardiol,2009,6:681-688.
• [2]Williams M,Shaw LJ,Raggi P,et al.Prognostic value of number and site of calcifi ed coronary lesions compared with the total score.J Am Coll Cardiol Img,2008,1:61-69.
• [3]Tanigawa J,Barlis P,Di Mario C.Heavily calcified coronary lesions preclude strut apposition despite high pressure balloon dilation and rotational atherectomy:in-vivo demonstration with optical conherence tomography.Circ J,2008,72:157-160.
• [4]Reimers B,von Birgelen C,van der Giessen WJ,et al.A word of caution on optimizing stent deployment in calcified lesions:acute coronary rupture with cardiac tamponade.Am Heart J,1996,131:192-194.
• [5]Mauri L,Bonan R,Weiner BH,et al.Cutting balloon angioplasty for the prevention of restenosis:Results of the cutting Balloon Global Randomized Trial.Am J Cardiol,2002,90:1079-1083.
• [6]Albiero R,Silber S,Di Mario C,et al.Cutting balloon versus conventional balloon angioplasty for the treatment of in-stent restenosis:Result of the restenosis cutting balloon evaluation trial(RESCUT).J Am Coll Cardiol,2004,43:943-949.
• [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:e574-651.
• [8]Moussa I,Di Mario C,Moses J,et al.Coronary stenting afterrotational atherectomy in calcifi ed and complex lesions Angiographic and clinical follow-up results.Circulation,1997,96:128-136.
• [9]Ellis SG,Popma JJ,Buchbinder M,et al.Relation of clinical presentation,stenosis morphology,and operator technique to the procedural results of rotational atheretomy and rotational atherectomy-facilitated angioplasty.Circulation,1994,89:882-292.
• [10]Kobayashi Y,Teirstein P,Linnemeier T,et al.Rotational atherectomy(stentablation)in a lesion with stent underexpansion due to heavily calcifi ed plaque.Catheter Cardiovasc Interv,2001,52:208-211.
• [11]Khattab AA,Otto A,Hochadel M,et al.Drug-eluting stents versus bare metal stents following rotational atherectomy for heavily calcifi ed coronary lesions:late angiographic and clinical follow-up results.J Interv Cardiol,2007,20:100-106.
• [12]Hoffmann R,Mintz GS,Kent KM,et al.Comparative early and nine-month results of rotational atherectomy,stents,and the combination of both for calcifi ed lesions in large coronary arteries.Am J Cardiol,1998,81:552-557.
• [13]Clavijo LC,Steinberg DH,Torguson R,et al.Sirolimus-eluting stents and clacified lesions:clinical outcomes of patients treated with and without rotational atherectomy.Catheter Cardiovasc Interv,2006,68:873-878.
• [14]Mezilis N,Dardas P,Ninios V,et al.Rotablation in the Drug Eluting Era:Immediate and Long-Term Results from a Single Center Experience.J Interv Cardiol,2012,23:249–253.
• [15]Benezet J,Diaz de la Llera LS,Cubero JM,et al.Drug-eluting stents following rotational atherectomy for heavily calcified coronary lesions:long-term clinical outcomes.J Invasive Cardiol,2011,23:28-32.
• [16]Rathore S,Matsuo H,Terashima M,et al.Rotational atherectomy for fibro-calcific coronary artery disease in drug eluting stent era:Procedural outcomes and angiographic follow-up results.Catheter Cardiovasc Interv,2010,75:919-927.
• [17]Cavusoglu E,Kini AS,Marmur JD,et al.Current Status of Rotational Atherectomy.Catheter Cardiovasc Interv,2004,62:485-498.
• [18]Safi an RD,Feldman T,Muller DW,et al.Coronary angioplasty and Rotablator atherectomy trial(CARAT):immediate and late results of a prospective multicenter randomized trial.Catheter Cardiovasc Interv,2001,53:213-220.
• [19]Whitlow PL,Bass TA,Kipperman RM,et al.Results of the study to determine rotablator and transluminal angioplasty strategy(STRATAS).Am J Cardio,2001,87:699-705.