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大隐静脉桥(SVG)病变是冠状动脉旁路移植(CABG)术后患者心绞痛复发的主要原因,经皮介入治疗(PCI)是治疗SVG的常用方法.SVG病变往往为较大、松软、易碎的斑块,内含大量坏死组织、胆固醇结晶、泡沫细胞以及血细胞成分,因此PCI面临的包括术中远段血管栓塞等并发症高、术后再狭窄率高以及临床MACE发生率高等问题.早期的SVG介入治疗经验主要参考了自体冠脉的PCI,如球囊预扩张后植入支架、高压释放支架、使用GPⅡb/Ⅲa受体拮抗剂等,但是近年的循证医学研究主张对于SVG行PCI应采用直接支架术及小直径支架低压释放,术中采用远端保护装置等.
Great saphenous vein bridge (SVG) is the main cause of recurrence of angina in patients undergoing coronary artery bypass grafting (CABG), and percutaneous interventional therapy (PCI) is a common method of treatment of SVG.SVG lesions tend to be large, soft, easy Broken plaque contains a large number of necrotic tissue, cholesterol crystals, foam cells and blood cell components, PCI is faced with complications such as intraoperative and distal vascular embolism, high postoperative restenosis and high incidence of clinical MACE problems. Of SVG interventional therapy experience mainly refers to the autologous coronary PCI, such as balloon dilatation stent implantation, high-pressure release stent, the use of GP Ⅱ b / Ⅲ a receptor antagonist, but in recent years, evidence-based medical advocacy for SVG PCI Should be used direct stent and small diameter stent low pressure, intraoperative use of remote protection devices.