Cardiac Catheterization Laboratory of the Cardiovascular Institute, Mount Sinai Hospital, Box 1030, One Gustave L. Levy Place, New York, NY 10029-6754, USA.
Cardiol Clin. 2010 Feb;28(1):55-70. doi: 10.1016/j.ccl.2009.10.001.
Coronary bifurcations are prone to develop atherosclerotic plaque because of turbulent blood flow and high shear stress. When compared with nonbifurcation coronary interventions, bifurcation interventions have historically reported a lower rate of procedural success, higher procedural costs, longer hospitalization, and higher clinical and angiographic restenosis. Treating bifurcation lesions is challenging, but a simple algorithm based on the side branch size, stenosis, and angulation can be used. The ongoing development of novel drug-eluting stent devices designed specifically for coronary bifurcations and the large randomized clinical trials being conducted to address their utility will add to the already present literature regarding treatment of coronary bifurcation lesions.
冠状动脉分叉处由于血流紊乱和高切应力而易发生动脉粥样硬化斑块。与非分叉冠状动脉介入治疗相比,分叉处介入治疗的手术成功率较低,手术费用较高,住院时间较长,临床和血管造影再狭窄率较高。治疗分叉病变具有挑战性,但可以使用基于侧支大小、狭窄和角度的简单算法。新型药物洗脱支架器械的不断发展,这些器械专门设计用于冠状动脉分叉处,以及为解决其应用而进行的大型随机临床试验,将增加已经存在的关于冠状动脉分叉病变治疗的文献。