药物洗脱支架进展.pptVIP

Concerns from Data Analysis in the Real-World CABG remains the standard of care for patients who require multivessel coronary revascularization. However, stents may be an alternative for patients at high risk for surgical complications or when an informed patient chooses a less invasive option. We would like to have used a longer follow-up period. Nevertheless, it would appear that the advantage of CABG would have persisted over the course of another year or two of follow-up, because our evidence of that tendency and because there is evidence of very late stent thrombosis in patients receiving DES. 10年通畅率95% 15年通畅率94％ 相当于DES 1年通畅率 Cover of LANCET Jan 2006 Conclusions DES in The Real-world CABG Patients were sicker Being older More co-morbidities Poorer LV function DES patients had higher rates of adverse outcomes Total mortality Revascularization TVR Q-wave MI Discussion and Comment What is the Differences between Bypass and PCI PCI is targeted at the “culprit” lesion or lesions. CABG is directed at the vessel including lesions and future culprits. March 2005 LIMA——The Golden Standard for LAD Tatoulis JTCVS,2004 Discussion and Comment CABG, the standard method for coronary revascularization Fuwai Database Discussion and Comment 0.6% Mortality Bypass surgery On-pump CABG Off-pump technique Mimi-incision Port-access Fast tract anesthesia Less Invasive 　Excellent perioperative outcomes 　Satisfactory long-term benefits Becoming less invasive The safety and effectiveness confirmed by 30 years of experiences * * Shengshou Hu M.D., FACC Department of Cardiac Surgery Fu Wai Hospital, Beijing, China DES 2007 UPDATE Textbook Theory Drug-eluting Stents Drug based therapeutics Bare-metal Stents Evolution of Cardiology The Era of Drug-eluting Stents More CAD patients prefer DES I prefer a less invasive and more comfortable therapy… The Era of Drug-eluting Stents