首页> 外文会议>1999 International Conference on Biomedical Optics >Applications of laser in ischemic heart disease in China
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Applications of laser in ischemic heart disease in China

机译:激光在中国缺血性心脏病中的应用

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Abstract: Current data demonstrate that laser coronaryangioplasty is most useful in complex lesions not wellsuited for percutaneous transluminal coronaryangioplasty (PTCA). It is not `stand-alone' procedure,and should be considered an adjunct to PTCA orstenting. To date, there are not data supportingreduction of restenosis. Direct myocardialrevascularization (DMR), either transmyocardialrevascularization (TMR) or percutaneous(catheter-based) myocardial revascularization (PMR),uses laser to create channels between ischemicmyocardium and left ventricular cavity. Candidatesinclude patients with chronic, severe, refractoryangina and those unable to undergo angioplasty orbypass surgery because conduits or acceptable targetvessels are lacking. Although the mechanisms of actionof DMR have not yet been clearly elucidated, butseveral theories have been proposed, including channelpatency, angiogenesis, and denervation. TMR, typicallyrequiring open thoracotomy, is effective for improvingmyocardial perfusion and reducing angina. Pilot studiesdemonstrate that clinical application of PMR isfeasible and safe and effective for decreasing angina.Late sequelae also remain to be determined. An ongoingrandomized clinical trial is comparing PMR withconventional medical therapy in patients with severe,refractory angina and disease unamenable to angioplastyor bypass surgery.!23
机译:摘要:当前数据表明,激光冠状动脉成形术在不适用于经皮腔内冠状动脉成形术(PTCA)的复杂病变中最有用。它不是“独立”过程,应被视为PTCA或PTCA的辅助。迄今为止,还没有支持减少再狭窄的数据。直接心肌血运重建术(DMR),无论是跨心肌血运重建术(TMR)还是经皮(基于导管的)心肌血运重建术(PMR),都使用激光在缺血性心肌和左心室之间建立通道。候选人包括患有慢性,严重,屈光不正的患者以及由于缺乏导管或可接受的靶血管而无法进行血管成形术或旁路手术的患者。尽管尚未清楚阐明DMR的作用机理,但已提出了多种理论,包括通道通畅性,血管生成和神经支配。 TMR通常需要开胸手术,可有效改善心肌灌注并减轻心绞痛。初步研究表明,PMR的临床应用是可行且安全有效的,可减轻心绞痛,后遗症尚待确定。一项正在进行的随机临床试验正在将PMR与常规药物治疗用于重度,难治性心绞痛和无法接受血管成形术或搭桥手术的疾病的患者!23

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