对多支血管的冠心病选择经皮血管成形术或者外科手术的血管成形术_Verghes英.pptVIP

下载本文档

1
0
约8.95千字
约 37页
2018-03-31 发布于江西
举报
版权申诉

对多支血管的冠心病选择经皮血管成形术或者外科手术的血管成形术_Verghes英.ppt

1、有哪些信誉好的足球投注网站（book118）网站文档一经付费（服务费），不意味着购买了该文档的版权，仅供个人/单位学习、研究之用，不得用于商业用途，未经授权，严禁复制、发行、汇编、翻译或者网络传播等，侵权必究。。
2、本站所有内容均由合作方或网友上传，本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺！文档内容仅供研究参考，付费前请自行鉴别。如您付费，意味着您自己接受本站规则且自行承担风险，本站不退款、不进行额外附加服务；查看《如何避免下载的几个坑》。如果您已付费下载过本站文档，您可以点击这里二次下载。
3、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等，请点击“版权申诉”（推荐），也可以打举报电话：400-050-0827(电话支持时间：9:00-18:30)。
4、该文档为VIP文档，如果想要下载，成为VIP会员后，下载免费。
5、成为VIP后，下载本文档将扣除1次下载权益。下载后，不支持退款、换文档。如有疑问请联系我们。
6、成为VIP后，您将拥有八大权益，权益包括：VIP文档下载权益、阅读免打扰、文档格式转换、高级专利检索、专属身份标志、高级客服、多端互通、版权登记。
7、VIP文档为合作方或网友上传，每下载1次，网站将根据用户上传文档的质量评分、类型等，对文档贡献者给予高额补贴、流量扶持。如果你也想贡献VIP文档。上传文档

对多支血管的冠心病选择经皮血管成形术或者外科手术的血管成形术_Verghes英

Percutaneous or Surgical Revascularization for Multivessel Coronary Artery Disease? Verghese Mathew, MD, FACC Consultant, Division of Cardiovascular Diseases and Department of Radiology Professor of Medicine, Mayo Clinic College of Medicine Revascularization Strategies 12-Year Survival in Patients with CAD 12-Year Survival in Patients with CAD Clinical Presentation Age Acute ischemic syndrome versus chronic stable angina Prior cardiac history (MI, CABG, intervention) Co-morbid conditions (diabetes, cerebrovascular disease, renal disease, lung disease) Functional impairment Ischemic burden Extension of Survival with CABG vs Medical Therapy After 10 Years CABG vs Stenting for MVD Meta-Analysis of ARTS, ERACI-II, MASS-II and SOS Increased Likelihood of Restenosis Lesion/Patient Subsets Small vessels Bifurcations Ostial CTO Bare metal ISR SVG AMI (thrombus) Diabetes mellitus CABG vs Drug-Eluting Stents in Multivessel Coronary DiseaseA Meta-Analysis on 24,268 Patients SYNTAX: Outcomes SYNTAX CABG/PCI Registries Outcomes Stratified by SYNTAX Score Procedural Differences Between SYNTAX CABG Randomized vs Registry CABG RCT CABG registry Variable n=897 n=644 Complete revasc (%) 63.2 (550/870) 74.7 (481/644) Graft revascularization (%) At least 1 arterial graft 97.3 (831/854) 96.7 (623/644) Arterial graft to LAD 95.6 (816/854) 94.7 (610/644) Double LIMA/RIMA 27.6 (236/854) 16.1 (104/644) Complete arterial 18.9 (161/854) 11.2 (72/644) revascularization Venous grafts only 2.6 (22/854) 3.3 (21/644) Procedural Differences Between SYNTAX PCI Randomized Cohort and the PCI Registry PCI RCT PCI registry Variable n=903 n=192 Complete revasc (%) 56.7 (508/896) 36.5 (70/192) Lesions, no. (mean ± SD) 4.4±1.8 4.5±1.8 Stents implanted 4.6±2.3 3.1±1.8(mean ± SD) Total length implanted, 86.1±47.9 58.5±41.2mean ± SD (mm) Range (mm) 8.0-324.0 8.0-252.0 Long stenting 33.2 (291/877) 12.2 (23/188)(100 mm) (%) SYNTAXStent Thrombosis and Symptomatic Graft Occlusion Per