International Circulation: Chinese physicians pay more attention to your presentation “Ten Most Important Technical Tips for Successful Complex PCI”， those ten tips are the most important issue for physicians Among the ten tips， which are due to operators’ experience， and which are the objective factors?
《国际循环》：国内医生首先很关注您的全体大会演讲“成功复杂冠脉介入治疗的十项最重要的技巧”。在这之中，哪些取决于术者经验，哪些是客观因素？毕竟术者经验需要时间和积累，而客观因素相对容易改变。
Dr. Fajadet : Thank you for welcoming me in Beijing for this fantastic meeting. This morning we have talked about 10 tips that we need to achieve to successful PCI and complex PCI procedures. This morning what we have done is to focus on the problem of bifurcation lesions and distal left main lesions. It is true that there are some rules to respect when we are treating this kind of lesions. The rules are the following; the first is the quality of angiography and of the diagnostic angiography. This looks evident but really it is the first step of the procedure， the quality， the correct selection of the views， to see the anatomy of the bifurcation and then we have to do the procedure， step by step， for all the patients. We have to respect all these steps. Then there are some different techniques to perform bifurcation. The best is to know at least perfectly， one major technique using 2 stents to treat the bifurcation but of course the best is to know all the techniques. Normally we can treat all the bifurcation with 1 or 2 techniques.
Fajadet教授：非常荣幸能受邀来北京参加这次盛会。今天上午我就成功实施PCI及复杂PCI治疗的十大技巧作了专题讲座。大会今天上午的日程主要关注的分叉病变及远端左主干病变。我们在治疗上述类型的病变时确实需要遵守一些规则，有如下技巧：第一，确保血管造影及诊断性造影的质量，这一点是毋庸置疑的，是成功实施PCI治疗的第一步。只有首先确保造影质量的前提下，正确了解分叉病变的解剖情况，我们才能逐步进行手术来治疗患者，需要强调的是，对PCI过程中的每个环节我们都需要重视。就分叉病变介入治疗而言，可以有不同的技术选择。我们最好能对所有的技术都有所了解和掌握，至少也需要知道和掌握其中一个最主要的技术那就是应用双支架治疗分叉病变。通常情况下，我们采用一种或两种技术就可以治疗所有的分叉病变。
International Circulation: Bioabsorbable stents can be called as the new milestone in the history of PCI， but it is at the beginning of development. What are the details should be noticed in the following research and clinical application?
《国际循环》：生物可吸收支架堪称介入史上的新里程碑，但仍处于起步阶段。目前已有少数支架在临床使用，您认为在临床应用和进一步科研中应注意哪些问题？
Dr. Fajadet: It is true that now we have the possibility to implant bioabsorbable stents or bioresorbable scaffolds and it is certainly the fourth revolution in interventional cardiology. We started by the balloon in 1979 and 1980 for ten years， then it was followed by the bare metal stent for the next 10 years. Since 2000s we had the drug eluting stents， and now it is the fourth step. The scaffold is a fantastic tool because while it could be， we have to demonstrate how it could give you the same outcome， the same result， maybe even better in the late follow up but again we have to demonstrate that. But if the scaffold can give you at least the same results as the drug eluting stent， the major advantage will be after 2 or 3 years， after the procedure， to absorb and have no metallic cage inside the vessel and this is really the revolution. Now the next step will be first to demonstrate the safety in the long term， the efficacy in the long term， and particularly when we treat complex coronary lesions as bifurcation， long lesions.， Then we want to certainly improve the scaffold and improve the platform itself by certainly a reduction of the thickness of the struts of the scaffold which is at present time， a little bit high. It is 150 microns but I am sure that when we can reduce the thickness of the scaffold from 150 microns to 100 microns or less than 100 microns， then I think there will be a real improvement in the technology and we can believe that in 10 years the scaffold will be the first choice of treatment for the treatment of coronary artery lesions.
Fajadet教授：现在，我们已经具备了置入生物可吸收支架的可能性。1979及1980年我们开始采用球囊扩张行介入治疗，十年后裸金属支架问世，21世纪初药物洗脱支架问世。近期研发的生物可吸收支架则掀起了介入心脏病学领域的第四次革命。生物可吸收支架是非常奇妙的，因为其可能能够达到与现有药物洗脱支架相同的结局或结果，如果能进行晚期随访甚至有可能显现出更好的结果。但是，这些都有待于研究证实。只要能够证实生物可吸收支架能够达到与药物洗脱支架相同的结果，鉴于与传统支架相比，其发生了根本变革，具有可吸收性、应用时血管内无金属支架，因此有望在PCI术后2年或3年后显现出巨大的优势。接下来，我们需要做的就是证明其长期安全性及长期疗效，尤其是应用其治疗复杂冠脉病变如分叉长病变时的长期疗效及安全性。目前的生物可吸收支架厚度一般在150微米左右，还是有些厚。因此，在确定其长期疗效及安全性后，我们希望通过减小支架厚度来进一步改进支架平台。我相信，如果我们能将支架厚度由原来的150微米减小至100微米甚至更低的话，则能真正促进生物可吸收支架技术上的进步。相信未来10年内，生物可吸收支架将成为冠状动脉疾病介入治疗的首选。