(齐国先田文)药物洗脱球囊治疗冠状动脉小血管病变updated课件.docxVIP

第六章 药物洗脱球囊治疗冠状动脉小血管病变 齐国先 田文 中国医科大学附属第一医院 老年心血管内科 一、病变背景及治疗现状 冠状动脉小血管病变的介入治疗是心脏介入医生每天都要面对的主题，在需要处理的冠状动脉病变中大约30～40%为小血管病变【 ADDIN EN.CITE  ADDIN EN.CITE.DATA  HYPERLINK \l _ENREF_1 \o Elezi, 1998 #1 1,  HYPERLINK \l _ENREF_2 \o Zeymer, 2011 #24 2 HYPERLINK \l _ENREF_1 \o Zeymer, 2011 #24 】。与普通病变相比，小血管病变往往与不良心脏事件（如支架内再狭窄、支架内血栓形成及再次血管重建等）密切相关【 HYPERLINK \l _ENREF_3 \o Agostoni, 2005 #2  ADDIN EN.CITE  ADDIN EN.CITE.DATA 3-5 HYPERLINK \l _ENREF_2 \o Kasaoka, 1998 #3  HYPERLINK \l _ENREF_3 \o Rathore, 2009 #4 】，可能与其独特的解剖学特点有关：小血管管腔内径狭小，支架植入后即使轻度的新生内膜增生即可导致明显的管腔丢失；此外，小血管病变多发生于女性、糖尿病或慢性肾功能不全等高危患者，多与长病变、钙化病变等高危病变共存【 HYPERLINK \l _ENREF_6 \o Akiyama, 1998 #5  ADDIN EN.CITE  ADDIN EN.CITE.DATA 6， HYPERLINK \l _ENREF_7 \o Briguori, 2002 #6  ADDIN EN.CITE EndNoteCiteAuthorBriguori/AuthorYear2002/YearRecNum6/RecNumDisplayTextstyle face=superscript7/style/DisplayTextrecordrec-number6/rec-numberforeign-keyskey app=EN db-id=twt0zsts59r907efp29xa52uvasxpawffrff6/key/foreign-keysref-type name=Journal Article17/ref-typecontributorsauthorsauthorBriguori, C./authorauthorTobis, J./authorauthorNishida, T./authorauthorVaghetti, M./authorauthorAlbiero, R./authorauthorDi Mario, C./authorauthorColombo, A./author/authors/contributorsauth-addressSan Raffaele Hospital, Milan, Italy./auth-addresstitlestitleDiscrepancy between angiography and intravascular ultrasound when analysing small coronary arteries/titlesecondary-titleEur Heart J/secondary-titlealt-titleEuropean heart journal/alt-title/titlesperiodicalfull-titleEur Heart J/full-titleabbr-1European heart journal/abbr-1/periodicalalt-periodicalfull-titleEur Heart J/full-titleabbr-1European heart journal/abbr-1/alt-periodicalpages247-54/pagesvolume23/volumenumber3/numberkeywordskeywordAged/keywordkeywordArteries/*ultrasonography/keywordkeyword*Coronary Angiography/keywordkeywordCoronary Artery Disease/epidemiology/radiography/ultrasonography/keywordkeywordCoronary Vessels/*ultrasonography/keywordkeywo