冠状动脉弥漫性长病变的介入治疗进展与技巧

Progress and Techniques of Interventional Treatment in Diffuse Long Coronary Lesions

虽然药物洗脱支架的应用改善了冠状动脉弥漫性长病变介入治疗的中长期临床结果,但对介入医师来说仍具有一定的挑战性。合理选择器械与治疗策略可以增加手术成功率和降低并发症发生率。覆盖全病变的单支架植入法是弥漫性病变支架植入的较好方法,但受多种因素影响。多支架重叠覆盖全病变法的中远期临床效果均较满意,具有较高的操作成功率和安全性,目前被较广泛应用,也有研究证实点状支架植入法的可行性。因此,在弥漫性长病变介入治疗处理过程需要根据术者的经验和不同的临床情况选用不同的处理策略与术式。

Although drug eluting stent（DES） constitutes a major achievement in mid-long term iuterven- tional treatment of diffuse coronary lesions, it is still a technical challenge for the interventional cardiologist. Reasonable choice of instruments and treatment strategies can increase the success rate of operation and reduce complications rate. Although full lesion coverage with one long stent implantation method is a good way in diffuse lesion treatment, it is often affected by many factors. Multiple overlapping stents approach is demonstrated to be a safe procedure in the treatment of diffuse coronary disease, with acceptable mid-long term clinical outcomes, which is now widely used. There are some studies which also demonstrated the feasi- bility of spot stenting. Therefore, interventional treatment strategies and modes should be chosen based on the experience of the cardiologist and the different clinical conditions.