Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
Korean Circ J. 2010 May;40(5):209-15. doi: 10.4070/kcj.2010.40.5.209. Epub 2010 May 27.
Treatment of coronary chronic total occlusions (CTOs) remains a challenging obstacle, posing a considerable barrier to achieving successful complete revascularization. By nature of their complexity, percutaneous CTO interventions are associated with lower rates of procedural success, higher complication rates, greater radiation exposure and longer procedure times compared with non-CTO interventions. In the last few years, development in guidewires, devices and the emergence of new techniques from Japanese centers resulted in higher success rates in the hands of experienced operators. The impact of drug eluting stents on restenosis has improved long-term outcomes after successful recanalization. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. This paper reviews the current devices and specialized crossing techniques of percutaneous intervention to relieve CTOs.
经皮冠状动脉慢性完全闭塞（CTO）的治疗仍然是一个具有挑战性的障碍，对实现完全血运重建构成了相当大的障碍。由于其复杂性，与非 CTO 介入相比，经皮 CTO 介入的手术成功率较低，并发症发生率较高，辐射暴露量较大，手术时间较长。在过去几年中，导丝、器械的发展以及日本中心新技术的出现，使得经验丰富的术者的成功率更高。药物洗脱支架对再狭窄的影响改善了成功再通后的长期预后。成功的血运重建与改善长期生存率、减轻症状、改善左心室功能和减少冠状动脉旁路移植术的需求有关。本文综述了目前用于缓解 CTO 的经皮介入的器械和特殊交叉技术。
