Alexopoulos Dimitrios, Varlamos Charalampos, Benetou Despoina-Rafailia
Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School Athens, Greece.
US Cardiol. 2020 Nov 23;14:e14. doi: 10.15420/usc.2020.13. eCollection 2020.
Complex percutaneous coronary intervention (PCI) patients are a high-risk population for ischemic complications. Antiplatelet therapy in such patients remains controversial, as the beneficial effects of the use of more potent agents or prolonged dual antiplatelet treatment (DAPT) on atherothrombotic complications are hindered by a concomitant increase in bleeding rates. The aim of this article is to describe ischemic and bleeding outcomes associated with complex PCI procedures and to compare different types and durations of DAPT regimens in terms of safety and efficacy outcomes. Issues concerning special patient groups, such as those with left main, chronic total occlusion, or bifurcation lesions, are discussed.
复杂经皮冠状动脉介入治疗(PCI)患者是缺血性并发症的高危人群。此类患者的抗血小板治疗仍存在争议,因为使用更强效药物或延长双联抗血小板治疗(DAPT)对动脉粥样硬化血栓形成并发症的有益作用会因出血率同时增加而受到阻碍。本文旨在描述与复杂PCI手术相关的缺血和出血结局,并比较不同类型和持续时间的DAPT方案在安全性和有效性方面的结局。还讨论了有关特殊患者群体的问题,例如左主干、慢性完全闭塞或分叉病变患者。