Is it time to change how we think about incomplete coronary revascularization?
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- 作者：Cristiano Spadaccioa ; cristiano.spadaccio@gjnh.scot.nhs.uk" class="auth_mail" title="E-mail the corresponding author ; Francesco Nappib ; Antonio Nennac ; Gwyn Beattiea ; Massimo Chelloc ; Fraser W.H. Sutherlanda
- 关键词：bSS ; baseline SYNTAX score ; CABG ; coronary artery bypass grafting surgery ; CAD ; coronary artery disease ; CCR ; complete coronary revascularization ; CST ; catestatin ; CTO ; chronic total occlusion ; FFR ; fractional flow reserve ; ICR ; incomplete coronary revascularization ; LAD ; left anterior descending artery ; LIMA ; left internal mammary artery ; MI ; myocardial infarction ; PCI ; percutaneous coronary interventions ; rSS ; residual SYNTAX score ; SRI ; Syntax Revascularization Index
- 刊名：International Journal of Cardiology
- 出版年：2016
- 出版时间：1 December 2016
- 年：2016
- 卷：224
- 期：Complete
- 页码：295-298
- 全文大小：319 K
文摘
The optimal degree of revascularization for patients with chronic multivessel coronary artery disease remains an unsolved issue. Intuitively, complete revascularization decreases cardiovascular events and improves outcomes compared to incomplete procedures, but in recent years the concept of incomplete revascularization moved from a sub-optimal or a defective treatment towards the most appropriate revascularization technique in some categories of patients. A reasonable level of incomplete anatomic revascularization has been shown to be safe and achievable with both percutaneous (PCI) and surgical procedures (CABG), despite with different long-term outcomes. What are the mechanisms underlying the clinical benefits of an incomplete revascularization and what are the factors explaining the discrepancy in the long-term clinical outcomes between the two modes of revascularization PCI and CABG? The biological consequences of coronary reperfusion might provide valuable hints in this context and at the same time cast new light on the way we think about incomplete revascularization.