Stiermaier T, Schuler G, Boudriot E, Desch S, Thiele H
Department of Internal Medicine-Cardiology, University of Leipzig Heart Center, Strümpellstrasse 39, Leipzig, Germany.
Herz. 2013 Mar;38(2):147-52. doi: 10.1007/s00059-012-3745-3.
Recent advances in percutaneous coronary intervention (PCI) have rekindled interest in this treatment modality also in the setting of unprotected left main stenosis. Randomized trials reported a similar risk of death or myocardial infarction between PCI and coronary artery bypass grafting (CABG). However, rates of stroke were higher after CABG, whereas patients undergoing PCI had a higher risk of repeat revascularization. Although CABG remains the standard of care for left main stenosis in current guideline recommendations, PCI is considered a reasonable alternative in patients with low to intermediate anatomical complexity and at increased surgical risk. An interdisciplinary assessment is indispensable in order to choose the best treatment option for each individual patient.
经皮冠状动脉介入治疗（PCI）的最新进展重新激发了人们对这种治疗方式在无保护左主干狭窄情况下的兴趣。随机试验报告称，PCI与冠状动脉旁路移植术（CABG）之间的死亡或心肌梗死风险相似。然而，CABG后的卒中发生率较高，而接受PCI的患者再次血运重建的风险较高。尽管在当前指南推荐中，CABG仍然是左主干狭窄的标准治疗方法，但对于解剖复杂性低至中等且手术风险增加的患者，PCI被认为是一种合理的替代方案。为每个患者选择最佳治疗方案，跨学科评估必不可少。
