International Circulation: Along with the development of PCI， unprotected LM bifurcation lesion never be the absolute contraindication， which is increasingly treated with PCI recently. And SYNTAX trial provides more choices to lower risk patients. Could you please introduce the development of LM bifurcation lesion treatment?

　　《国际循环》：随着导管介入技术的快速发展和技术的不断进步，无保护左主干病变的经皮冠脉介入（PCI）治疗已不再是绝对禁忌，并且逐渐增多。特别是SYNTAX的研究结果让低危患者有了更多治疗选择。纵观左主干病变治疗的多年发展，您认为其中有哪些里程碑？

　　Dr. Kirtane: Sure I think in the past the left main was an area that we did not want to treat with PCI and the reason is because the outcomes were not all that great. With the advent of drug eluting stents and newer techniques and technologies， and also data from trials like SYNTAX which show that in the less complex overall disease， treatment of the left main can be very effective and safe， so there has been more interest in doing this. Obviously PCI is less invasive than bypass surgery so for the right patients， as long as they agree， and that makes sense to them， PCI in this situation is a very very viable alternative. There are several case demonstrations and discussions here at CIT demonstrating how to do it， how to do it safely， and in which patients as well.

　　Kirtane教授：过去我们不太愿意采用PCI治疗左主干病变，其原因在于既往PCI治疗左主干病变的结局并不都非常好。但是，随着药物洗脱支架、新技术及新工艺的发展与进步以及SYNTAX研究等试验数据表明“在整体病情相对不是太复杂的患者中，采用PCI治疗左主干病变是非常有效和安全的”，我们对采用PCI治疗左主干病变越来越感兴趣。很显然，与外科搭桥手术相比，PCI给患者带来的创伤会更小。因此，对同意并适宜行PCI治疗的患者而言，PCI是一个非常可行的替代搭桥手术的治疗选择。在本届CIT大会上也有几个有关左主干病变PCI治疗应如何实施、如何安全实施以及在哪些患者中实施的病例展示与讨论。

　　International Circulation: IABP Scholarship Awarding is made its debut in CIT. For the technology to be appropriate application， especially in special patients， what’s your suggestion?

　　《国际循环》：今年CIT首次设立IABP奖学金，对IABP的合理应用，尤其是特殊人群中，您有哪些建议？

　　Dr. Kirane: I think that the use of adjunctive support during PCI is something we need to know how to do because certain cases of PCI can be high risk. If we do the PCI by obstructing flow to the coronaries we can make patients sicker but we want to make them allowed to tolerate the procedure better so there are a variety of ways to do this. Some ways include IABP， more support such as the Impella device， and even cardiopulmonary bypass but in general， for this type of program this showcases the ability for younger physicians to come to CIT and present cases where they have used， for instance the IABP successfully to enable patients to get through procedures that they might not have otherwise gotten through.

　　Kirtane教授：我认为，鉴于很多PCI患者都是高危患者，我们需要知道如何在PCI期间应用辅助装置。PCI治疗时阻断流向冠脉的血流会加重患者的病情，因此我们需要确保患者能够更好地耐受这种手术。现在，有很多方法如IABP、心室辅助装置Impella及体外循环均可提高患者对PCI手术的耐受性。就IABP奖学金项目而言，我们希望借助该平台向来参加CIT大会的年轻医生展示在其他方法可能无法确保患者耐受手术时成功实施IABP使患者耐受PCI手术的病例，以期提高年轻医生应用IABP的能力。