我认为对于分叉病变患者不需要延长双联抗血小板治疗的疗程,因为我们已经取得了令人满意的最佳结果。必须指出新一代支架尤其是使用了生物可吸收聚合物的支架,已经显示了比第一代支架更低的血栓形成发生率。
International Circulation: There is still controversy about whether a single-stent approach or a complex 2-stent approach is better in treating bifurcation lesions. What is your opinion on this problem and what changes to the approach in PCI need to be made?
Dr Colombo: I am not so sure that we have such a controversy. I think the controversy is in how frequently we use a 2-stent approach. Some interventionists say we need two stents in 20% of bifurcation cases. Others say we need it in 30-35% of cases. We all agree that not every bifurcation can be treated with one stent and there are some complex bifurcations that need two stents. The only number we are debating here is in how many we really need two stents. Some people are more aggressive and suggest one-third of cases; others suggest one-fifth. I think the major debate however is over.
《国际循环》:对于到底应该采用单支架策略还是复杂的双支架策略治疗分叉病变的争议仍在继续。您对这一问题持何种观点?您认为应作出哪些改变?
Dr Colombo: 我并不认为还存在这种争议。我认为争议在于使用双支架策略的频率。一些介入专家称,在20%的分叉病变患者中需要置入2枚支架;另外一些人则说该比例为30%~35%。我们都同意以下观点,即并非每1例分叉病变都可以通过置入1枚支架来解决,的确有一些复杂分叉病变需要置入2枚支架。我们争论的唯一话题就是,到底有多少分叉病变真正需要置入2枚支架。一些专家更为积极,认为有三分之一的病例;而另外一些专家认为是五分之一。然而,我认为最大的争议已经结束了。