体外膜肺氧合在无明显休克高危经皮冠状动脉介入治疗中的应用进展

Application of extracorporeal membrane oxygenation in high-risk percutaneous coronary intervention without obvious shock

经皮冠状动脉介入治疗(PCI)对于不适合手术或拒绝手术的高危冠状动脉疾病患者而言,是一种可行的血管重建策略。然而,该类高危患者在球囊充气或复杂操作过程中,存在较高的血流动力学崩溃风险,特别是当冠状动脉夹层伴血管闭合或无复流发生时。静脉-动脉体外膜肺氧合(VA-ECMO)作为一种临时机械循环支持(MCS)技术已被引入高危PCI,其在手术过程中可提供充分的全身灌注。本文就体外膜肺氧合(ECMO)预防性用于技术复杂的无明显休克的高危PCI相关研究进展进行综述。

Percutaneous coronary intervention(PCI) is a feasible strategy for vascular remodeling in high-risk coronary artery disease patients who are not suitable for surgery or refuse surgery. However,such high-risk patients are at higher risk of hemodynamic collapse during balloon inflating or complex procedures,especially when coronary artery dissection with vessel closure or without re-flow occurs. Veno-arterial extracorporeal membrane oxygenation(VA-ECMO) has been introduced as a temporary mechanical circulatory support(MCS)for high-risk PCI,which can provide adequate systemic perfusion during surgery. This article reviewed the studies on the preventive use of extra-corporeal membrane oxygenation(ECMO) in technically complex high-risk PCI without obvious shock.