International Circulation: Incidence of stent malapposition is relatively higher in PCI in complex bifurcation lesions. Could you talk about your experience in preventing stent malapposition in complex bifurcation lesions? Dr Colombo: In bifurcation lesions, most of the malapposition is acute malapposition, which means that at the end of the procedure the stent has not been deployed appropriately and this is the one that we can prevent and we should prevent. An acquired malapposition is really an event due to the toxicity of the medication on the polymer which seems to be much lower in the second generation stents. In acute malapposition, I believe the best way to check the result is with IVUS. IVUS will tell us if the stent is well deployed and that there is good contact between the wall and the stent struts and will tell us what to do in order to improve the result. 《国际循环》:在复杂分叉病变的PCI术中,支架贴壁不良的发生率仍然相当高。能否请您谈谈您在复杂分叉病变PCI术中避免支架贴壁不良的经验? Dr Colombo:在分叉病变PCI术中,大多数贴壁不良是一个急性过程,即在手术即将结束时支架未被恰当地释放,这是我们能够、也是应该避免的。获得性贴壁不良实际上是因聚合物中的药物的毒性所造成的事件,在第二代支架中这种情况已经非常少见。对于急性贴壁不良,我认为最好的办法是使用IVUS检查支架释放后的结果。IVUS将告诉我们支架是否被正确地释放,以及血管壁和支架杆之间是否贴附良好,并告诉我们应如何采取措施以改善结果。
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