操作员经验和IVUS指导对复杂PCI后长期临床结果的预后影响
Ki Hong Choi1, Sang Yoon Lee1, Young Bin Song1
1Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
JACC. Cardiovascular interventions
|July 26, 2023
概括
经验丰富的操作人员和复杂的穿皮冠状动脉干预 (PCI) 中的血管内超声波 (IVUS) 使用可以降低长期的心脏风险. 在PCI程序中,对经验较少的运营商来说,IVUS的好处更大.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗成像医学成像
背景情况:
- 血管内超声波 (IVUS) 支持复杂的穿皮冠状动脉干预 (PCI).
- 长期结果和运营商经验对复杂PCI中IVUS使用的影响仍然未得到充分研究.
研究的目的:
- 评估操作者经验如何影响病变复杂性,长期临床结果和复杂PCI中的IVUS指导相互作用.
- 根据操作员的经验,评估IVUS使用的差异性影响.
主要方法:
- 从单一中心注册处分析了6005名接受复杂PCI的患者,使用药物释放支架.
- 根据IVUS使用和操作员经验 (≤5年与经验丰富) 的患者分层.
- 主要终点:心脏死亡或目标血管心肌梗塞 (TVMI) 的组合,长达10年.
主要成果:
- 经验丰富的操作员更频繁地使用IVUS,心脏死亡/TVMI的风险更低.
- 与单独血管造影相比,IVUS使用显著降低了对经验较少和经验丰富的操作人员的心脏死亡/TVMI风险.
- IVUS的好处在经验较少的操作人员中更为明显,IVUS使用和操作人员经验之间存在显著的相互作用 (P=0.037).
结论:
- 经验丰富的操作人员和复杂的PCI期间的IVUS使用都与减少长期心脏死亡或TVMI有关.
- 对于经验较少的运营商来说,IVUS对结果的积极影响更为显著.
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