医学
传统PCI
冠状动脉疾病
经皮冠状动脉介入治疗
旁路移植
动脉
药物治疗
冠状动脉搭桥手术
经皮
心脏病学
内科学
重症监护医学
外科
心肌梗塞
作者
Torsten Doenst,Holger Thiele,Jörg Haasenritter,Thorsten Wahlers,Steffen Maßberg,Axel Haverich
出处
期刊:Deutsches Arzteblatt International
[Deutscher Arzte-Verlag GmbH]
日期:2022-10-21
标识
DOI:10.3238/arztebl.m2022.0277
摘要
The first coronary artery bypass operation (CABG) was performed on May 2, 1960. The first percutaneous coro - nary intervention (PCI) was performed almost 20 years later. Since then, the invasive treatment of coronary artery disease (CAD) has moved into the spotlight of cardiac medical care.We summarize the current status of medical and invasive CAD treatment through a selective review of the literature.More than 800 000 patients currently undergo invasive diagnostic and therapeutic procedures for CAD in Germany each year. The number of coronary artery bypass grafting (CABG) procedures rose to 65 000/year by the turn of the millennium and has been declining since then. In contrast, the number of PCIs in Germany rose to approximately 350 000/year by 2017, and a beginning decline is being observed at present. This development occurred even though, for elective patients, a survival advantage from an invasive procedure compared to medical therapy has been shown in direct comparison only for CABG.Conservative treatment is always the baseline treatment and has undergone major advances in the last few decades. Moreover, non-invasive coronary evaluation with computed tomography, as well as non-invasive cardiac stress imaging studies, are increasingly replacing primary invasive coronary evaluations. In this review, we illustrate a mechanistic concept of the appropriate use of CABG and PCI that can improve patient care, while underscoring the importance of interdisciplinary and intersectoral collaboration.
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