[IHF2011]冠心病介入治疗中支架选择策略及并发症——Prof. Ting 专访
<International Circulation>: What are the common types of coronary stents currently used in clinical practice? For each, could you summarize their advantages and disadvantages?
<International Circulation>: As was pointed out in the discussion in your session today, bypass surgery is a very personal decision for the patient and particularly unpopular amongst Chinese candidates. As an interventionalist then, are you open to the patient’s opinion and would indeed encourage a decision to undergo CABG?
《国际循环》:我们讨论的议题中,CABG 术的选择是患者的私人决策,它在中国并不普及,您作为介入医生您是否接受患者的决定并鼓励患者行CABG术?
Prof Ting: Absolutely. Patients come in different sizes and shapes as well. We can’t assume that one size fits all and that all patients want the same thing. When you have preference-sensitive medical decisions that need to be made, we are in a situation where there is no right or wrong. Bypass surgery, a drug-eluting stent or a bare-metal stent will have fairly equal outcomes in terms of length of life and quality of life and what the patient has to do in order to undergo that specific treatment. Most of our procedures for revascularization (which include bypass surgery, drug-eluting stent and bare-metal stent) are typically those types of situations where there are differential trade-offs between having a bypass operation, a drug-eluting stent or a bare-metal stent. When you talk to your patients, I think 80% of them want to engage in that conversation. They want to know more about those risks and benefits and alternatives, learn about them and see which fits best into their own lifestyle and their own preferences, values and goals. However, there are still 20%-30% of patients who say after that conversation, “Doc, what do you recommend for me?”, and that is perfectly OK, because at the end of the day, it is not about what I would do for myself as an interventional cardiologist, it is about what the patient wants for themselves. I feel that my purpose is to guide them. If their decision is that they want to have bypass surgery and they understand the risks and benefits and alternatives, I would fully support them choosing bypass surgery as the means of revascularization.
Prof Ting: 当然,患者的病情和临床治疗方案多种多样,我们不可能用一种方法解决所有患者的问题,也不可能要求患者的选择一致。如果需要患者决策,我们要清楚他们的决定并没有绝对的对与错。CABG,DES,BMS的选择对于远期寿命、患者的生活质量以及接受治疗的准备均没有明显差别。我们的血运重建治疗