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各种类型经皮心血管介入治疗围手术期抗栓治疗。

Periprocedural antithrombotic therapy during various types of percutaneous cardiovascular interventions.

机构信息

Cardiocenter, University Hospital Kralovske Vinohrady, Third Faculty of Medicine, Charles University Prague, Srobarova 50, 100 34 Prague 10, Czech Republic

Cardiocenter, University Hospital Kralovske Vinohrady, Third Faculty of Medicine, Charles University Prague, Srobarova 50, 100 34 Prague 10, Czech Republic.

出版信息

Eur Heart J Cardiovasc Pharmacother. 2016 Apr;2(2):131-40. doi: 10.1093/ehjcvp/pvv053. Epub 2015 Dec 11.

Abstract

Percutaneous catheter-based interventions became a critically important part of treatment in modern cardiology, improving quality of life as well as saving many life. Due to the introduction of foreign materials to the circulation (either temporarily or permanently) and due to a certain damage to the endothelium or endocardium, the risk of thrombotic complications is substantial and thus some degree of antithrombotic therapy is needed during all these procedures. The intensity (dosage, combination, and duration) of periprocedureal antithrombotic treatment largely varies based on the type of procedure, clinical setting, and comorbidities. This manuscript summarizes the current therapeutic approach to prevent clotting (and bleeding) during a large spectrum of interventions: acute and elective coronary interventions, acute stroke interventions and elective carotid stenting, electrophysiology procedures, interventions for structural heart disease, and peripheral arterial interventions.

摘要

经皮导管介入治疗已成为现代心脏病学治疗中至关重要的一部分,提高了生活质量并挽救了许多生命。由于将外来材料引入循环系统(无论是暂时的还是永久性的)以及对内皮层或心内膜造成一定的损伤,血栓并发症的风险很大,因此在所有这些程序中都需要进行某种程度的抗血栓治疗。围手术期抗血栓治疗的强度(剂量、组合和持续时间)在很大程度上取决于手术类型、临床环境和合并症。本文总结了预防大范围介入治疗中血栓形成(和出血)的当前治疗方法:急性和选择性冠状动脉介入治疗、急性脑卒中介入治疗和选择性颈动脉支架置入术、电生理程序、结构性心脏病介入治疗和外周动脉介入治疗。

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