261.4 📌 章末速蚘

261.4.0.0.1 Types
  • LHC (coronary, LV pressures), RHC (PA, CO), PCI (revascularization), Structural (TAVR, MitraClip, etc.)
261.4.0.0.2 Indications
  • STEMI (emergent), NSTEMI/UA (24-72 hr), stable angina (failure of medical therapy), HF etiology, PAH
261.4.0.0.3 Access
  • Radial preferred 2024 (less bleeding); femoral for complex
261.4.0.0.4 Functional Assessment
  • FFR < 0.80 = ischemia
  • iFR < 0.89 = ischemia
261.4.0.0.5 Stents
  • DES = standard
  • DAPT post-DES (6-12 months typically; 12 months in ACS)
261.4.0.0.6 CABG vs PCI
  • High SYNTAX (> 32) / Left main complex / Diabetic + multi-vessel = CABG
261.4.0.0.7 Complications
  • Bleeding, contrast nephropathy, stroke, MI / stent thrombosis, dissection, tamponade, death
261.4.0.0.8 PAH Hemodynamics
  • Mean PA ≥ 25 + PAWP ≀ 15 + PVR > 3 WU
261.4.0.0.9 Constrictive vs Restrictive
  • Constrictive: equalized diastolic + discordance LV/RV systolic with respiration
  • Restrictive: LV diastolic > RV diastolic + concordance
261.4.0.0.10 盧醫垫 hint
  • STEMI: primary PCI within 90 min door-to-balloon (< 60 ideal)
  • Multi-vessel diabetic: CABG > PCI (FREEDOM)
  • FFR/iFR for intermediate lesions (avoid unnecessary PCI)
  • Contrast nephropathy: hydrate + limit contrast in CKD/DM/elderly
  • DAPT individualized based on bleeding + ischemic risk