Boukhris Marouane, Tomasello Salvatore Davide, Marzà Francesco, Galassi Alfredo Ruggero
Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Italy.
J Saudi Heart Assoc. 2015 Apr;27(2):109-17. doi: 10.1016/j.jsha.2014.04.006. Epub 2014 May 6.
Among all coronary lesions, the decision-making process for the treatment of unprotected left main (ULM) stem lesions is still challenging. Indeed, the optimal therapeutic strategy for patients with ULM disease remains controversial: coronary artery bypass grafting was established as the gold standard, but it is without doubt that percutaneous coronary intervention (PCI) performed by experienced operators achieves good results at long term follow up, especially in cases where the ostium and/or shaft of ULM are treated. Thanks to the widespread use of invasive assessment of atherothrombotic ULM stenosis, improved selection of PCI cases and techniques of stenting, better outcomes are now possible. This review seeks to define the place of PCI in ULM disease by describing the different modalities of ULM stenosis assessment.
在所有冠状动脉病变中，无保护左主干（ULM）病变的治疗决策过程仍然具有挑战性。事实上，ULM疾病患者的最佳治疗策略仍存在争议：冠状动脉旁路移植术已被确立为金标准，但毫无疑问，经验丰富的术者进行的经皮冠状动脉介入治疗（PCI）在长期随访中能取得良好效果，尤其是在治疗ULM开口和/或主干的病例中。由于对动脉粥样硬化性ULM狭窄进行侵入性评估的广泛应用、PCI病例选择的改善以及支架置入技术的进步，现在有可能获得更好的治疗结果。本综述旨在通过描述ULM狭窄评估的不同方式来确定PCI在ULM疾病中的地位。
