New York, NY (Nowemapa 04, 2021) ʻO ka hoʻohana ʻana i kahi ʻenehana hou i kapa ʻia ʻo ka quantitative flow ratio (QFR) e ʻike pono a ana i ka paʻakikī o nā ʻāʻī aʻa hiki ke alakaʻi i nā hopena maikaʻi loa ma hope o ka percutaneous coronary intervention (PCI), e like me kahi. ʻO ka noiʻi hou i hana pū ʻia me ke kumu kula ʻo Mount Sinai.
ʻO kēia noiʻi, ʻo ia ka mea mua e nānā i ka QFR a me kāna mau hopena lapaʻau e pili ana, hiki ke alakaʻi i ka hoʻohana ākea ʻana o QFR ma ke ʻano he ʻokoʻa i ka angiography a i ʻole nā uea kaomi e ana i ka paʻakikī o nā blockages, a i ʻole nā lesions, i nā maʻi me ka maʻi ʻaʻaʻa coronary.Ua hoʻolaha ʻia nā hopena noiʻi ma ka Pōʻalima, Nowemapa 4, ma ke ʻano he hoʻokolohua lapaʻau hope loa ma ka Transcatheter Cardiovascular Therapeutics Conference (TCT 2021), a paʻi pū ʻia ma The Lancet.
"No ka manawa mua i loaʻa iā mākou ka hōʻoia lapaʻau ʻo ka koho lesion me kēia ʻano hana e hoʻomaikaʻi i nā hopena no nā poʻe maʻi me ka maʻi coronary artery e mālama ana i ka stent," wahi a ka mea kākau kiʻekiʻe ʻo Gregg W. Stone, MD, Luna Hoʻokele no ka Pūnaehana Ola ʻo Mount Sinai a me Professor of ʻO ka lāʻau lapaʻau (Cardiology), a me ke ola olakino a me ke kulekele lehulehu, ma ke kula ʻo Icahn School of Medicine ma Mount Sinai."Ma ka pale ʻana i ka manawa, nā hoʻopiʻi, a me nā kumuwaiwai ʻē aʻe e pono ai e ana i ka nui o ka lesion me ka hoʻohana ʻana i kahi uea kaomi, pono kēia ʻenehana maʻalahi e hoʻonui nui i ka hoʻohana ʻana i ka physiology i nā poʻe maʻi e hana ana i nā kaʻina hana catheterization cardiac."
ʻO ka poʻe maʻi me ka maʻi ʻaʻaʻa coronary—ke kūkulu ʻia ʻana o ka pā i loko o nā aʻa e alakaʻi ai i ka ʻeha o ka umauma, pōkole o ka hanu, a me ka puʻuwai puʻuwai - e hana pinepine i ka PCI, kahi kaʻina hana ʻole e hoʻohana ai nā cardiologists interventional i kahi catheter e kau i nā stents i loko o ka coronary blocked. nā aʻa e hoʻihoʻi hou i ke kahe koko.
ʻO ka hapa nui o nā kauka ke hilinaʻi nei i ka angiography (X-ray o nā ʻaʻaʻa coronary) no ka hoʻoholo ʻana i ke aʻaʻa i loaʻa i ka paʻa koʻikoʻi loa, a hoʻohana i kēlā loiloi ʻike e hoʻoholo ai i nā aʻa e mālama ai.ʻAʻole maikaʻi kēia ʻano hana: ʻoi aku ka paʻakikī a ʻoi aʻe ka paʻakikī o kekahi mau poloka ma mua o ko lākou ʻano maoli a ʻaʻole hiki i nā kauka ke haʻi pololei mai ka angiogram wale nō ka mea i hoʻopilikia nui ʻia ke kahe koko.Hiki ke hoʻomaikaʻi ʻia nā hopena inā koho ʻia nā ʻeha i ka stent me ka hoʻohana ʻana i kahi uwea kaomi e ʻike ai i nā mea e keakea ana i ke kahe koko.Akā ʻo kēia kaʻina hana e hoʻolōʻihi i ka manawa, hiki ke hoʻopiʻi i nā pilikia, a komo i nā kumukūʻai keu.
Hoʻohana ka ʻenehana QFR i ke kūkulu hou ʻana o ke aʻa 3D a me ke ana ʻana i ka wikiwiki o ke kahe ʻana o ke koko e hāʻawi ana i nā ana pololei o ka hāʻule ʻana o ke kaomi ma waena o kahi poloka, e ʻae i nā kauka e hoʻoholo maikaʻi i nā mea aʻa e stent i ka wā PCI.
No ke aʻo ʻana i ka hopena o ka QFR i nā hopena maʻi, ua hana nā mea noiʻi i kahi hoʻokolohua multi-center, randomized, makapō o 3,825 mau mea komo ma Kina e hana ana i ka PCI ma waena o Dekemaba 25, 2018, a me Ianuali 19, 2020. Ua loaʻa paha nā maʻi i ka puʻuwai 72 mau hola ma mua, a i ʻole. Ua loaʻa i hoʻokahi aʻaʻa coronary me hoʻokahi a ʻoi aʻe paha nā poloka i ana ʻia e ka angiogram ma waena o 50 a 90 pākēneka i haiki.ʻO ka hapalua o ka poʻe maʻi i hana i ke kaʻina hana angiography-alakaʻi maʻamau e pili ana i ka loiloi ʻike, aʻo ka hapa ʻē aʻe i ka hoʻolālā alakaʻi QFR.
Ma ka hui alakaʻi QFR, ua koho nā kauka e mālama ʻole i nā moku 375 i manaʻo mua ʻia no PCI, hoʻohālikelike ʻia me 100 i ka hui alakaʻi angiography.No laila ua kōkua ka ʻenehana i ka hoʻopau ʻana i ka nui o nā stents pono ʻole.Ma ka hui QFR, ua mālama pū nā kauka i nā moku 85 i manaʻo ʻole ʻia no PCI i hoʻohālikelike ʻia me 28 i ka hui alakaʻi angiography.No laila, ua ʻike ʻia ka ʻenehana i nā ʻeha ʻeha ʻē aʻe i mālama ʻole ʻia.
ʻO ka hopena, ua loaʻa i nā poʻe maʻi i ka pūʻulu QFR ka haʻahaʻa haʻahaʻa o hoʻokahi makahiki o ka hōʻeha puʻuwai ma mua o ka hui angiography-wale nō (65 mau maʻi vs. ola like.Ma ka hōʻailona makahiki hoʻokahi, 5.8 pakeneka o nā maʻi i mālama ʻia me ke kaʻina hana PCI alakaʻi QFR ua make paha, ua loaʻa i ka puʻuwai puʻuwai, a i ʻole pono e hoʻihoʻi hou i ka revascularization (stent), ke hoʻohālikelike ʻia me 8.8 pakeneka o nā mea maʻi e hana ana i ke kaʻina hana PCI alakaʻi angiography. , he 35 pakeneka hoemi.Ua hōʻike ka poʻe noiʻi i kēia mau hoʻomaikaʻi koʻikoʻi i nā hopena i ka QFR e ʻae i nā kauka e koho i nā moku kūpono no PCI a pale pū i nā kaʻina hana pono ʻole.
"ʻO nā hualoaʻa mai kēia ho'āʻo hoʻokolohua makapō nui i ka maʻi maʻi, a like me ka mea i manaʻo ʻia me ke alakaʻi ʻana i ka uea PCI.Ma muli o kēia mau ʻike, ma hope o ka ʻae ʻana i ke kānāwai e manaʻo wau e hoʻohana nui ʻia ʻo QFR e nā cardiologists interventional e hoʻomaikaʻi i nā hopena no kā lākou poʻe maʻi.wahi a Kauka Stone.
Tags: Aortic Diseases and Surgery, Heart - Cardiology & Cardiovascular Surgery, Icahn School of Medicine ma Mount Sinai, Mount Sinai Health System, Patient Care, Gregg Stone, MD, FACC, FSCAI, ResearchE pili ana i ka Pūnaehana Ola ʻo Mount Sinai
ʻO ka Pūnaehana Ola Ola ʻo Mount Sinai kekahi o nā ʻōnaehana hoʻonaʻauao kula nui loa ma New York metro area, me ka ʻoi aku o 43,000 mau limahana e hana ana ma waena o ʻewalu mau haukapila, ʻoi aku ma mua o 400 mau maʻi maʻi maʻi, kokoke i 300 labs, kahi kula kahu hānai, a me kahi kula alakaʻi o ka lāʻau lapaʻau. hoʻonaʻauao puka.Hoʻonui ka mauna ʻo Sinai i ke olakino no nā kānaka a pau, ma nā wahi a pau, ma o ka lawe ʻana i nā pilikia mālama ola kino paʻakikī o ko mākou manawa - ʻike a hoʻohana i ka ʻike ʻepekema hou a me ka ʻike;ka hoʻomohala ʻana i nā lāʻau lapaʻau palekana a ʻoi aku ka maikaʻi;hoʻonaʻauao i ka hanauna hou o nā alakaʻi olakino a me nā mea hou;a me ke kākoʻo ʻana i nā kaiāulu kūloko ma o ka hāʻawi ʻana i ka mālama kiʻekiʻe i ka poʻe āpau e pono ai.
Ma o ka hoʻohui ʻia ʻana o kāna mau haukapila, labs, a me nā kula, hāʻawi ʻo Mount Sinai i nā hoʻonā mālama olakino piha mai ka hānau ʻana a hiki i ka geriatrics, e hoʻohana ana i nā ala hou e like me ka naʻauao a me nā ʻikepili ʻoiai e mālama ana i nā pono olakino a me nā manaʻo ma ke kikowaena o nā lāʻau lapaʻau āpau.Aia i loko o ka Pūnaehana Ola ma kahi o 7,300 mau kauka mālama mua a kūikawā;13 mau kikowaena hana maʻi maʻi ma waho o nā ʻāpana ʻelima o New York City, Westchester, Long Island, a me Florida;a ʻoi aku ma mua o 30 mau kikowaena olakino kaiaulu pili.Hoʻopaʻa mau ʻia mākou e ka US News & World Report's Best Hospitals, e loaʻa ana i ke kūlana "Honor Roll" kiʻekiʻe, a ua kūlana kiʻekiʻe loa: No. /Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.Aia ʻo New York Eye and Ear Infirmary of Mount Sinai i ka helu 12 ma Ophthalmology.ʻO ka US News & World Report's "Best Children's Hospitals" i hoʻonohonoho ʻia i ka Halemaʻi keiki ʻo Mount Sinai Kravis ma waena o nā mea maikaʻi loa o ka ʻāina ma nā ʻoihana pediatric.
Ka manawa hoʻouna: Nov-10-2023