Cardiovascular Research Foundation, New York, NY, USA.
ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy.
Lancet. 2017 Aug 19;390(10096):793-809. doi: 10.1016/S0140-6736(17)31957-8.
Although it is the method used by most interventional cardiologists to assess the severity of coronary artery disease and guide treatment, coronary angiography has many known limitations, particularly the fact that it is a lumenogram depicting foreshortened, shadowgraph, planar projections of the contrast-filled lumen rather than imaging the diseased vessel itself. Intravascular imaging-intravascular ultrasound and more recently optical coherence tomography-provide a tomographical or cross-sectional image of the coronary arteries. These techniques are clinically useful to answer questions such as whether the stenosis is clinically relevant; the identification of the culprit lesion; or whether the plaque (or patient) is at high risk of future adverse events. They can also be used to optimise stent implantation to minimise stent-related adverse events, provide answers to the likelihood of distal embolisation or peri-procedural myocardial infarction during stent implantation, and provide reasons for stent thrombosis or restenosis. This review considers the usefulness of intravascular imaging in day-to-day practice.
虽然冠状动脉造影术是大多数介入心脏病学家评估冠状动脉疾病严重程度和指导治疗的方法，但它有许多已知的局限性，特别是它是一种描绘缩短、阴影、对比填充管腔的平面投影的管腔造影术，而不是对病变血管本身进行成像。血管内成像——血管内超声，以及最近的光学相干断层扫描——提供了冠状动脉的断层或横截面图像。这些技术在临床上有用，可以回答诸如狭窄是否具有临床意义、确定罪犯病变、斑块（或患者）是否有发生未来不良事件的高风险等问题。它们还可用于优化支架植入术，以最大程度地减少支架相关不良事件，提供在支架植入过程中远端栓塞或围手术期心肌梗死的可能性的答案，并为支架血栓形成或再狭窄提供原因。本综述考虑了血管内成像在日常实践中的有用性。
