- 期刊
左主冠狀動脈疾病血管成形術之現況－藥物釋放型支架的影響
Current Status of Left Main Coronary Angioplasty-Implication of Drug-eluting Stent
摘要
傳統上，左主冠狀動脈疾病的治療是以外科繞道手術爲首選，但隨著冠狀動脈介入性治療的進步，包括技術的突破和藥物釋放型支架的發明，內科醫師針對左主冠狀動脈的血管成形術也開始發展，並有了初步良好的結果。自2006年開始，比較使用藥物釋放型支架的介入性治療與外科冠狀動脈繞道手術的研究結果陸續發表，不論是單一醫學中心或是多機構的比較結果，都顯示接受藥物釋放支架治療的病患術後發生死亡、腦中風與心肌梗塞的比率與接受繞道手術的病患都是不相上下的。台灣目前心臟科醫師針對左主冠狀動脈疾病的介入性治療也有了不錯的初步成果，與國外醫學界的發展同步進行。然而，目前大規模隨機的比較實驗成果仍付之闕如；此外，左主冠狀動脈疾病的病灶特徵與介入性治療的方法有許多分類方式，治療的結果也是差異頗大，因此仍有待更進一步的研究釐清。不過隨著冠狀動脈介入性治療技術的突飛猛進，與支架的推陳出新（包括藥物釋放型支架與分叉型支架的發明），內科醫師在左主冠狀動脈的治療將扮演愈來愈重要的角色；未來幾年，左主冠狀動脈的治療也將有革命性的進展。
並列摘要
Traditionally, the treatment of choice for left main coronary artery disease (LMCA) was bypass surgery. With the advancement of the percutaneous coronary intervention (PCI) including technical breakthrough and development of drug-eluting stents (DES), the results of PCI in LMCA have improved significantly. Since 2006, several studies comparing PCI using drug-eluting stent and coronary artery bypass surgery have been published. Death, cerebrovascular events, and myocardial infarction rates in patients receiving DES treatment or bypass surgery are similar. The experience in Taiwan has also shown that the result of PCI for LMCA is not inferior to the published data. Despite these facts, there was a paucity of large randomized controlled trial. In addition, there is no consensus on the ideal interventional strategy for different types of LMCA. However, we may still anticipate revolutionary progress of LMCA treatment in the near future, and interventionalists will play a more and more important role with the evolving technology in new generation DES.
延伸閱讀
- Huang, S. Y., Chou, P. C., Huang, C. H., & Chen, P. H. (2008). 包覆式支架成功的治療醫源性冠狀動脈併主動脈剝離. 輔仁醫學期刊, 6(1), 47-52. https://www.airitilibrary.com/Article/Detail?DocID=18102093-200803-6-1-47-52-a
- Tsai, J. P., Wang, K. T., Yeh, H. I., & Hou, C. J. Y. (2007). 冠狀動脈瘤形成於Paclitaxel塗藥支架置放術之後. Acta Cardiologica Sinica, 23(1), 50-55. https://www.airitilibrary.com/Article/Detail?DocID=10116842-200703-23-1-50-55-a
- 唐思齊（2019）。冠狀動脈血管介入性治療中以放大視野與支架精細顯影成像術的輻射劑量評估〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2706201911235400
- Akcay, A., Koroglu, S., Kaya, H., Koleoglu, M., & Acar, G. (2010). An Unusual Appearance of Double Right Coronary Artery. Cardiology Research and Practice, 2010(), 6-8. https://doi.org/10.4061/2010/123846
- Chen, Y. C., Yeh, H. I., Hou, C. J. Y., & Tsai, C. H. (2006). Single Coronary Artery with Multiple Cardiac Anomalies. 中華放射線醫學雜誌, 31(2), 85-89. https://www.airitilibrary.com/Article/Detail?DocID=10188940-200604-31-2-85-89-a