Is it time to change how we think about incomplete coronary revascularization?

Autor: Spadaccio C; Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Clydebank, Glasgow, UK. Electronic address: cristiano.spadaccio@gjnh.scot.nhs.uk., Nappi F; Department of Cardiac Surgery, Centre Cardiologique du Nord de Saint-Denis, Paris, France., Nenna A; Department of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy., Beattie G; Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Clydebank, Glasgow, UK., Chello M; Department of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy., Sutherland FW; Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Clydebank, Glasgow, UK.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2016 Dec 01; Vol. 224, pp. 295-298. Date of Electronic Publication: 2016 Sep 18.
DOI: 10.1016/j.ijcard.2016.09.055
Abstrakt: The optimal degree of revascularization for patients with chronic multivessel coronary artery disease remains an unsolved issue. Intuitively, complete revascularization decreases cardiovascular events and improves outcomes compared to incomplete procedures, but in recent years the concept of incomplete revascularization moved from a sub-optimal or a defective treatment towards the most appropriate revascularization technique in some categories of patients. A reasonable level of incomplete anatomic revascularization has been shown to be safe and achievable with both percutaneous (PCI) and surgical procedures (CABG), despite with different long-term outcomes. What are the mechanisms underlying the clinical benefits of an incomplete revascularization and what are the factors explaining the discrepancy in the long-term clinical outcomes between the two modes of revascularization PCI and CABG? The biological consequences of coronary reperfusion might provide valuable hints in this context and at the same time cast new light on the way we think about incomplete revascularization.
(Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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