无保护左主干病变介入治疗的研究进展  

Research progress in interventional therapy of unprotected left main coronary artery disease

作　　者：贾玉虎 王悦喜 JIA Yu-hu;WANG Yue-xi(Graduate School of Inner Mongolia Medical University,Hohhot 010000,China)

机构地区：[1]内蒙古医科大学研究生学院,内蒙古自治区呼和浩特市010000

出　　处：《中国心血管病研究》2022年第4期371-378,共8页Chinese Journal of Cardiovascular Research

基　　金：内蒙古医科大学附属医院重点项目(NYFYZD020)。

摘　　要：无保护左主干病变(UPLMD)属于冠心病高危类型之一,及时有效的血运重建能够改善患者预后。长期以来冠状动脉旁路移植术(CABG)是左主干病变的首选治疗方案,但是随着介入诊疗技术的日渐成熟,越来越多的临床证据支持经皮冠状动脉介入治疗(PCI),如何选择安全有效的血运重建策略是目前研究热点。复杂分叉病变概念的出现,改变了既往左主干分叉病变介入治疗策略选择理念,对于符合复杂分叉病变定义的左主干分叉病变患者,计划内双支架策略能带来更好的结果。腔内影像学相对于传统的冠脉造影有着明显的优势,能进一步明确血管结构,优化左主干病变患者的介入治疗。本文围绕左主干病变血运重建策略选择、左主干分叉病变PCI策略选择及左主干病变腔内影像学临床应用的相关研究进展作一综述。Unprotected left main artery disease(UPLMD) is one of the high-risk types of coronary heart disease.Timely and effective revascularization can improve patients’ prognosis.Coronary artery bypass grafting(CABG) has long been the first choice for the treatment of the left main coronary disease.However,with the increasing maturity of interventional diagnosis and treatment techniques,the growing clinical evidence supports percutaneous coronary intervention(PCI).The selection of safe and effective revascularization strategies is a current research hotspot.The concept of complex bifurcation lesions has changed the previous philosophy of interventional strategy selection for the left main bifurcation lesions.For the patients with the left main bifurcation lesions that meet the definition of the complex bifurcation lesions,the planned 2-stent strategy can lead to better outcomes.Intracoronary imaging has significant advantages over the conventional coronary angiography in further defining the vascular structure and optimizing the interventional treatment of the patients with the left main disease.This article reviews the research progress related to the selection of the revascularization strategies for the left main disease,the selection of PCI strategies for the left main bifurcation lesions and the clinical application of the intracoronary imaging for the left main disease.

关 键 词：无保护左主干病变 冠状动脉分叉病变 经皮冠脉介入治疗 血管内超声 

分 类 号：R541.4[医药卫生—心血管疾病]