Rab Tanveer, King Spencer B
From the Division of Cardiology, Emory University School of Medicine, Atlanta, GA.
Cardiol Rev. 2018 Sep/Oct;26(5):219-229. doi: 10.1097/CRD.0000000000000213.
Percutaneous coronary intervention of the left main coronary artery has evolved through registries and meta analyses, supported by results from the EXCEL [Everolimus-Eluting Stents (EES) or Bypass Surgery for Left Main Coronary Artery Disease] and NOBLE (Percutaneous Coronary Angioplasty versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials as an acceptable alternative to coronary artery bypass grafting in patients with low and intermediate Syntax scores. Advances in stenting strategies and the availability of larger diameter drug-eluting stents improve patient safety and optimize procedural and patient outcomes.
经皮冠状动脉介入治疗左主干冠状动脉病变已通过注册研究和荟萃分析得到发展，EXCEL（依维莫司洗脱支架治疗左主干冠状动脉疾病与冠状动脉搭桥术对比研究）和NOBLE（经皮冠状动脉血管成形术与冠状动脉搭桥术治疗无保护左主干狭窄对比研究）试验的结果支持其作为Syntax评分低和中等的患者冠状动脉搭桥术的可接受替代方案。支架置入策略的进展以及更大直径药物洗脱支架的可用性提高了患者安全性，并优化了手术和患者预后。
