보험인정기준 상세내용

■ 고시 신설 전체내용

1. 허가사항 범위 내에서 투여 시 요양급여함을 원칙으로 함.

2. 허가사항 범위를 초과하여 아래와 같은 경우에 관상동맥주입 시에도 요양급여를 인정함.

- 아 래 -

가. 경피적관상동맥중재술(PCI) 중 no-reflow가 발생한 경우

나. 관상동맥내 압력측정술 시 최대충혈 유도



■ 고시 신설 고시번호(시행일자)

고시 제2022-207호(2022.9.1.)



■ 고시 신설 사유

국내？외 허가사항, 교과서, 가이드라인, 임상연구문헌, 관련 학회 의견 등을 참고하여, 경피적관상동맥중재술에서 no-reflow가 발생한 경우 및 관상동맥내 압력측정술 시 최대충혈 유도를 위해 관상동맥주입에 요양급여 인정하여 급여기준을 신설함.



■ 관련문헌 등

？ Myocardial Infarction: A Companion of Braunwald’s Heart Disease 1e (2016) > CHAPTER 17. Approach to Percutaneous Coronary Intervention in Myocardial Infarction

？ Textbook of Interventional Cardiology 8e (2019) > CHAPTER 27. Bypass Graft Intervention

？ 일조각, 순환기학 제2판(2010) > 제22장. 관상동맥의 생리학적 검사



？ ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction (2013)

？ 대한심혈관중재학회, 심혈관중재매뉴얼 (2016)

？ LW Klein et al. Society of Cardiac Angiography and Interventions: Suggested Management of the no-reflow Phenomenon in the Cardiac Catheterization Laboratory. Catheterization and Cardiovascular Interventions 2006;60:194？201

？ 군자출판사, SNUH 심혈관 진료 매뉴얼(2014)

？ Gabor G et al. Standardization of Fractional Flow Reserve Measurements. JACC 2016;68(7) 742-53

？ Interventional Cardiac Catheterization Handbook 4e (2018)

？ EP Navarese et al. Adenosine improves post-procedural coronary flow but not clinical outcomes in patients with acute coronary syndrome: A meta-analysis of randomized trials. Atherosclerosis 2012 May;222(1) 1-7.

？ Niccoli G et al. Open-Label, Randomized, Placebo-Controlled Evaluation of Intracoronary Adenosine or Nitroprusside After Thrombus Aspiration During Primary Percutaneous Coronary Intervention for the Prevention of Microvascular Obstruction in Acute Myocardial Infarction. JACC Intv 2013;6:580？9

？ Grygier M et al. New Method of Intracoronary Adenosine Injection to Prevent Microvascular Reperfusion Injury in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention. Am J Cardiol 2011;107:1131？1135.

？ M Marzilli et al. Beneficial Effects of Intracoronary Adenosine as an Adjunct to Primary Angioplasty in Acute Myocardial Infarction. Circulation 2000;101:2154-2159.

？ Shereif H et al. Management of no-reflow Phenomenon in the Catheterization Laboratory. JACC 2017;10(3): 215-23

？ C Christian et al. Comparison of Intracoronary Versus Intravenous Administration of Adenosine for Measurement of Coronary Fractional Flow Reserve. Circ Cardiovasc Interv. 2015 May;8(5) 1-7

？ J Adjedj et al. Intracoronary Adenosine, Dose-response relationship with hyperemia. JACC Intv 2015;8:1422？30