支架
医学
血管内超声
传统PCI
经皮冠状动脉介入治疗
放射科
光学相干层析成像
再狭窄
冠状动脉疾病
新生内膜增生
急性冠脉综合征
心脏病学
心肌梗塞
作者
Akiko Maehara,Mitsuaki Matsumura,Ziad A. Ali,Gary S. Mintz,Gregg W. Stone
标识
DOI:10.1016/j.jcmg.2017.09.008
摘要
Procedural guidance with intravascular ultrasound (IVUS) imaging improves the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) by: 1) informing the necessity for lesion preparation; 2) directing appropriate stent sizing to maximize the final stent area and minimize geographic miss; 3) selecting the optimal stent length to cover residual disease adjacent to the lesion, thus minimizing geographic miss; 4) guiding optimal stent expansion; 5) identifying acute complications (edge dissection, stent malapposition, tissue protrusion); and 6) clarifying the mechanism of late stent failure (stent thrombosis, neointimal hyperplasia, stent underexpansion or fracture, or neoatherosclerosis). Optical coherence tomography (OCT) provides similar information to IVUS (with some important differences), also potentially improving acute and long-term patient outcomes compared to angiography-guided PCI. The purpose of this review is to describe the similarities and differences between IVUS and OCT technologies, and to highlight the evidence supporting their utility to improve PCI outcomes.
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