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1、解放军总医院血管外科贾鑫、郭伟、刘小平、尹太、熊江、马晓辉等 从TASC分级演变展望PAD治疗前景TASC Trans-Atlantic Inter-Society Consensus committee TASC 2000, included Working Group members from 14 societies composed of vascular surgery, interventional radiology, angiology, and cardiology, as well as experts in health economy and epidemiology.
2、 TASC 2007 included Working Group members from 16 societies, not only from North America and Europe, but also from Japan, Australia, and South Africa. Further, podiatry experts and experts of evidence-based medicine were included. A Collaboration of the American College of Cardiology, the American H
3、eart Association, the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society for Vascular Medicine and Biology, and the PAD Coalition.Class IBenefit RiskProcedure/ Treatment SHOULD
4、 be performed/ administeredClass IIaBenefit Risk Additional studies with focused objectives neededIT IS REASONABLE to perform procedure/administer treatmentClass IIbBenefit Risk Additional studies with broad objectives needed; Additional registry data would be helpfulProcedure/Treatment MAY BE CONSI
5、DERED Class IIIRisk Benefit No additional studies neededProcedure/Treatment should NOT be performed/administered SINCE IT IS NOT HELPFUL AND MAY BE HARMFULLevel B单中心随机对照研究;或非随机性研究推荐级别及证据分级Level A 经过 多中心随机对照研究得到的一致性结论Level C无随机对照研究的专家共识或制定的治疗规 范。TASC ITASC II A Endovascular treatment of choice B Endo
6、vascular treatment is recommended C Surgical treatment is recommended D Surgical treatment of choiceIIIIIISingle Stenosis or occlusion 5cm TASC演变: D C (腹股沟上)B/C A (腹股沟下) 腹股沟下病变演变明显效果? 问题:看病不看人 TASC分级是PAD治疗的纲领绝对性 TASC分级是不断演变的相对性(基于病变) 腔内治疗是PAD治疗的发展方向 We are seeing an increasing population requiring prevention and also treatment and more focus on endovascular treatment. The TASC classification of lesions has been kept as such, but modified to reflect increased evidence for endovascular treatment of more extensive lesions. -Lars Norgren, MD 谢谢 谢谢