[1]马洪俊.冠状动脉左主干病变的治疗研究[J].医学信息,2019,32(14):42-45.[doi:10.3969/j.issn.1006-1959.2019.14.015]
　MA Hong-jun.Study on the Treatment of Left Main Coronary Artery Disease[J].Journal of Medical Information,2019,32(14):42-45.[doi:10.3969/j.issn.1006-1959.2019.14.015]
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冠状动脉左主干病变的治疗研究()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年14期
页码:
42-45
栏目:
综述
出版日期:
2019-07-15

文章信息/Info

Title:
Study on the Treatment of Left Main Coronary Artery Disease
文章编号:
1006-1959（2019）14-0042-04
作者:
马洪俊
天津海滨人民医院心血管内科，天津 300280
Author(s):
MA Hong-jun
Department of Cardiology,Tianjin Haibin People's Hospital,Tianjin 300280,China
关键词:
左主干病变; 经皮冠状动脉介入治疗; 冠状动脉旁路移植术
Keywords:
Key words：Left main disease; Percutaneous coronary intervention; Coronary artery bypass grafting
分类号:
R654.2
DOI:
10.3969/j.issn.1006-1959.2019.14.015
文献标志码:
A
摘要:
冠状动脉左主干病变（LMCA）因其高危险、高死亡率，一直受到心脏科医师的高度重视，且在不断的努力探索LMCA的有效治疗策略。单纯药物治疗预后差，冠状动脉旁路移植术（CABG）一直以来是LMCA的首选治疗策略，但随着经皮冠状动脉介入治疗（PCI）相关技术的发展，新一代药物涂层支架的问世，使LMCA患者的PCI治疗预后显著改善。本文总结了近年来CABG和PCI治疗LMCA的相关研究，以探讨LMCA的最佳治疗策略。
Abstract:
Abstract：Coronary artery left main disease (LMCA) has been highly valued by cardiologists because of its high risk and high mortality, and is constantly striving to explore effective treatment strategies for LMCA. The simple prognosis of drug therapy alone, coronary artery bypass grafting (CABG) has long been the preferred treatment strategy for LMCA, but with the development of percutaneous coronary intervention (PCI)-related technology, the advent of a new generation of drug-eluting stents, the prognosis of PCI in patients with LMCA was significantly improved. This article summarizes recent studies on the use of CABG and PCI in the treatment of LMCA to explore the optimal treatment strategy for LMCA.

参考文献/References:

[1]Bonaca MP,Bhatt DL,Cohen M,et al.Long-term use of ticagrelor in patients with prior myocardial infarction[J].N Engl J Med,2015,372(19):1791-1800. [2]Lee PH,Ahn JM,Chang M,et al.Left main coronary artery disease:secular trends in patient characteristics,treatments,and outcomes[J].J Am Coll Cardiol,2016,68(11):1233-1246. [3]Palmerini T,Benedetto U,Biondi-Zoccai G,et al.Long-term safety of drug-eluting and bare-metal stents:evidence from a comprehensive network meta-analysis[J].J Am Coll Cardiol,2015,65(23):2496-2507. [4]Nerlekar N,Ha FJ,Verma KP,et al.Percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass grafting for unprotected left main coronary artery stenosis:a meta-analysis of randomized trials[J].Circ Cardiovasc Interv,2016,9(12):004729. [5]Ahn JM,Roh JH,Kim YH,et al.Randomized trial of stents versus by-pass surgery for left main coronary artery disease:5-year outcomes of the PRECOMBAT study[J].J Am Coll Cardiol,2015,65(20):2198-2206. [6]Morice MC,Serruys PW,Kappetein AP,et al.Outcomes in patients with left main disease treated with either percutaneous coronary intervention using paclitaxel-eluting stents or coronary artery bypass graft treatment in the Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery(SYNTAX)trial[J].Circulation,2010,121(24):2645-2653. [7]Buszman PE,Buszman PP,Banasiewicz-Szkróbka,et al.Left main stenting in comparison with surgical revascularization:10-Year Outcomes of the(Left Main Coronary Artery Stenting)LE MANS Trial[J].JACC Cardiovasc Interv,2016,9(4):318-327. [8]Windecker S,Kolh P,Alfonso F,et al.2014 ESC/EACTS Guidelines on myocardial revasculariza-tion: The Task Force on Myocardial Revascularization of the European Society of Cardiology(ESC)and the European Association for Cardio-Thoracic Surgery(EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)[J].Eur Heart J,2014,35(37):2541-2619. [9]Palmerini T,Serruys P,Kappetein AP,et al.Clinical outcomes with percutaneous coronary revascularization vs coronary artery bypass grafting surgery in patients with unprotected left main coronary artery disease:a metaanalysis of 6 randomized trials and 4,686 patients[J].Am Heart J,2017,190(5):54-63. [10]Makikallio T,Holm NR,Lindsay M,et al.Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis(NOBLE):a prospective,randomised,open-label,non-inferiority trial[J].Lancet,2016,388(10061):2743-2752. [11]Borges N,Kapadia SR,Ellis SG,et al.Unprotected Left Main Coronary Artery Disease:Management in the Post NOBLE and EXCEL Era[J].Interv Cardiol,2017,12(2):92-96. [12]Giacoppo D,Colleran R,Cassese S,et al.Percutaneous coronaryintervention vs coronary artery bypass grafting in patients with left main coronary artery stenosis:a systematic review and meta-analysis[J].JAMA Cardiol,2017,2(10):1079-1088. [13]Bing R,Yong AS,Lowe HC.Percutaneous transcatheter assessment of the left main coronary artery:current status and future directions[J].JACC Cardiovasc Interv,2015,8(12):1529-1539. [14]Andell P,Karlsson S,Mohammad MA,et al.Intravascular ultrasound guidance is associated with better outcome in patients undergoing unprotected left main coronary artery stenting compared with angiography guidance alone[J].Circ Cardiovasc Interv,2017,10(5):e004813. [15]Oviedo C,Christiansen EH,Gudmundsdottir IJ,et al.Instantaneous wave-free ratio versus fractional flow reserve to guide PCI[J].N Engl J Med,2017,376(19):1813-1823. [16]Ye Y,Yang M,Zhang S,et al.Percutaneous coronary intervention in left main coronary artery disease with or without intravascular ultrasound:a meta-analysis[J].PLoS One,2017,12(6):e0179756. [17]Tian J,Guan C,Wang W,et al.Intravascular Ultrasound Guidance Improves the Long-term Prognosis in Patients with Unprotected Left Main Coronary Artery Disease Undergoing Percutaneous Coronary Intervention[J].Sci Rep,2017,7(1):2377. [18]Zimmermann FM,De Bruyne B,Pijls NH,et al.Rationale and design of the Fractional Flow Reserve versus Angiography for Multivessel Evaluation(FAME)3 Trial:a comparison of fractional flow reserve-guid-ed percutaneous coronary intervention and coronary artery bypass graft surgery in patients with multivessel coronary artery disease[J].Am Heart J,2015,170(4):619-626. [19]Hamilos M,Muller O,Cuisset T,et al.Long-term clinical outcome after fractional flow reserve-guided treatment in patients with angiographically equivocal left main coronary artery stenosis[J].Circulation,2009,120(15):1505-1512. [20]Fearon WF,Yong AS,Lenders G,et al.The impact of downstream coronary stenosis on fractional flow reserve assessment of intermediate left main coronary artery disease:human validation[J].JACC Cardiovasc Interv,2015,8(3):398-403. [21]Nappi AG,Boden WE.Does physiology trump anatomy as the"Best Course"to guide PCI decision making and outcomes[J].J Am Coll Cardiol,2016,67(14):1712-1714. [22]Upadhaya S,Baniya R,Madala S,et al.Drug-eluting stent placement versus coronary artery bypass surgery for unprotected left main coronary artery disease:a meta-anal-ysis of randomized controlled trials[J].J Card Surg,2017,32(2):70-79.

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更新日期/Last Update: 2019-07-15