冠心病介入治疗进展__培训课件.pptVIP

* * 一年研究结果为：心血管不良事件(死亡、心肌梗死、再次PCI和CABG)在常规PCI组中为18.4%，而FFR组只有13.2%（P=0.02）。与现在的通过血管造影指导支架释放技术相比，FFR指导的PCI可以使血管再重建率下降30%，死亡和心肌梗死风险下降35%。 Revascularisation rates, which were a major concern in Syntax, where lower in the FFR group and whilst not statistically significant .we will see that the trend is towards a greater divergence as time goes on. These numbers compare favourably with those patients in the cabg arm of the Syntax trial. Also total number of was was strikingly lower for patients undergoing PCI guided by Fract Flow Res These MACE rates are comparable with those of the 3 VSD cabg subgroup group in the Syntax trial. In real life terms what impact does this have on patient populations? Recent data extrapolations in both Sweden and in Belgium showed that 300 deaths can be prevented in the FAME cohort of patients. These are indeed dramatic figures. * * Therefore,…., in ALL ASPECTS…. * * * 2008TCT公布了第一个生物可吸收依维莫司洗脱支架试验——ABSORB研究，经过2年随访其结果表明患者置入可吸收依维莫司药物洗脱支架，其MACE发生率低。该研究共入组了30例患者，研究结果显示：PCI术后6个月随访时钙化密度与超声强度较前明显降低，但与2年期随访时相比没有显著区别。2年期随访时血管面积减少(-3.31%)与斑块面积增加(4.73%)没有统计学意义，管腔面积明显减少(-9.66%)，而最小管腔面积减少(-12.78%)有统计学差异(P=0.03)。在6个月至第二年时段，经光学相干断层显像（OCT）检测显示超过1/3的支架结构被降解，OCT发现基线时的支架支撑网孔为29，6个月时为48，两年时为38。 * * * * IVUS results (24 pts) Post-PCI Follow-up % Difference p-value Vessel area (mm2) 13.55 13.49 -0.4 NS EEM-Stent Area (mm2) 7.47 8.08 +8.2 0.003 Stent area (mm2) 6.08 5.37 -11.7 0.001 Neointimal hyperplasia area (mm2) 0 0.30 NA NA Lumen area (mm2) 6.08 5.07 -16.6 0.001 Stent area obstruction (%) 0 5.54 NA NA Serial IVUS Characteristic Everolimus eluting stent platform (n=30) Mean minimum lumen diameter (MLD) (mm) 1.10 Percent stenosis (%) 59 Lesion length (mm) 8.66 LAD Lesion location (%) 50 Type B1 lesions (%) 65 ABSORB Trial: Baseline Characteristics ACC 2007 Characteristic Everolimus eluting stent platform (n=26) Mean MLD (mm) 2.33 Stenosis (%) 16 ABSORB Trial: Post-procedure Data ACC 2007 Characteristic Everolimus eluting stent platform (n=26) In