冠心病治疗 2008.ppt
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1、Prof. Yean L. Lim AM Professor & Director, Center for Cardiovascular Therapeutics Western Health University of Melbourne,Qianjiang PCI Meeting Hangzhou, 1 Aug 2008,CAD Therapy 2008,PCI for CAD: 2008 Considerations,Revascularization Therapy for CAD, Who & When ? If Revascularization indicated, PCI or
2、 CABG ? If PCI, DES or BMS ? Complex PCI Strategy (STEMI, LM, MVD, Diabetic, Bifurcation CTO),“Treats Patients Not Lesions”,Stable Angina : Maximal Medical Therapy, deferred PCI 穩定心絞痛 : 药物治疗後介入 ACS : Early PCI , especially High-Risk Pts 急性冠脈綜合症 : 介入(高危) + 葯物治疗,治病人 不只治病変,PCI for CAD: 2008 Considerati
3、ons,Revascularization therapy for CAD, Who & When ? If Revascularization indicated, PCI or CABG ? If PCI, DES or BMS ? Complex PCI Strategy (STEMI, LM, MVD, Diabetic, Bifurcation CTO),Which Revascularization ?,Vessel & Lesion Factors (Lesion Complexity),Patient Factors (Diabetes, Renal),Secondary Fa
4、ctors (Costs, Culture),Immediate Risk & Long-term Benefit,SVD, Suitable Lesion(s) PCI Technically Feasible Incomplete Revasc, TLR,MVD, PCI Risk CABG Complete Revasc Better Long-term Result,PCI,CABG,Pre-DES PCI vs CABG (Angina Relief),Pre-DES PCI vs CABG (Mortality),DES PCI vs CABG (Mortality),DES PC
5、I vs CABG (MACCE),DES PCI vs CABG in MVD,Hospital & Doctors Clinical Outcomes Matter,PCI for CAD: 2008 Considerations,Revascularization therapy for CAD, Who & When ? If Revascularization indicated, PCI or CABG ? If PCI, DES or BMS ? Complex PCI Strategy (STEMI, LM, MVD, Diabetic, Bifurcation CTO),BM
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