Estrada J Raider, Paul Jonathan D, Shah Atman P, Nathan Sandeep
University of Chicago Medicine, Section of Cardiology, Chicago, Illinois, US.
Interv Cardiol. 2014 Mar;9(1):17-22. doi: 10.15420/icr.2011.9.1.17.
Complex percutaneous coronary intervention (PCI), encompassing an ever-expanding range of challenging lesion sets and patient populations, accounts for a significant proportion of PCI procedures being performed currently. Specific lesion types associated with lower rates of procedural success and higher rates of recurrence or major adverse cardiac events (MACE) include multivessel disease, unprotected left main coronary artery disease, fibrocalcific or undilatable lesions, chronic total occlusions, degenerated saphenous vein graft lesions, thrombotic lesions, and bifurcation disease. Validated tools and technical strategies currently exist to address most procedural scenarios encountered and should be familiar to the complex PCI operator. Anticipated clinical outcomes, projected resource utilization, and cost considerations should all factor into the decisions of when, how, and in whom to intervene.
复杂经皮冠状动脉介入治疗（PCI）涵盖了范围不断扩大的具有挑战性的病变类型和患者群体，在目前正在进行的PCI手术中占很大比例。与手术成功率较低、复发率或主要不良心脏事件（MACE）较高相关的特定病变类型包括多支血管病变、无保护左主干冠状动脉病变、纤维钙化或不可扩张病变、慢性完全闭塞病变、退化的大隐静脉桥血管病变、血栓性病变和分叉病变。目前已有经过验证的工具和技术策略来应对大多数遇到的手术情况，复杂PCI手术操作者应熟悉这些策略。预期的临床结果、预计的资源利用情况和成本考量都应纳入何时、如何以及对谁进行干预的决策因素。
