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有创和无创成像技术以及钙修饰疗法在冠状动脉钙化评估和管理中的作用。

The role of invasive and non-invasive imaging technologies and calcium modification therapies in the evaluation and management of coronary artery calcifications.

作者信息

Wopperer Samuel B, Kotronias Rafail, Marin Federico, Benenati Stefano, Della Mora Francesco, Portolan Leonardo, Banning Adrian P, De Maria Giovanni Luigi

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.

Oxford Heart Centre, John Radcliffe Hospital, Oxford University Hospitals, NHS Foundation Trust, Oxford, United Kingdom.

出版信息

Front Cardiovasc Med. 2023 Apr 6;10:1133510. doi: 10.3389/fcvm.2023.1133510. eCollection 2023.

DOI:10.3389/fcvm.2023.1133510
PMID:37089880
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10118029/
Abstract

The treatment of coronary artery disease (CAD) has advanced significantly in recent years due to improvements in medical therapy and percutaneous or surgical revascularization. However, a persistent obstacle in the percutaneous management of CAD is coronary artery calcification (CAC), which portends to higher rates of procedural challenges, post-intervention complications, and overall poor prognosis. With the advent of novel multimodality imaging technologies spanning from intravascular ultrasound to optical coherence tomography to coronary computed tomography angiography combined with advances in calcium debulking and modification techniques, CACs are now targets for intervention with growing success. This review will summarize the most recent developments in the diagnosis and characterization of CAC, offer a comparison of the aforementioned imaging technologies including which ones are most suitable for specific clinical presentations, and review the CAC modifying therapies currently available.

摘要

近年来，由于药物治疗以及经皮或外科血管重建技术的进步，冠状动脉疾病（CAD）的治疗取得了显著进展。然而，CAD经皮治疗中一个持续存在的障碍是冠状动脉钙化（CAC），它预示着更高的手术挑战率、干预后并发症发生率以及总体预后不良。随着从血管内超声到光学相干断层扫描再到冠状动脉计算机断层扫描血管造影等新型多模态成像技术的出现，以及钙减容和改性技术的进步，CAC现在已成为越来越成功的干预靶点。本综述将总结CAC诊断和特征描述的最新进展，比较上述成像技术，包括哪些技术最适合特定的临床表现，并回顾目前可用的CAC改性疗法。

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