Minneapolis VA Healthcare System, One Veterans Drive (111-C), Minneapolis, MN, USA.
Curr Cardiol Rep. 2013 Feb;15(2):334. doi: 10.1007/s11886-012-0334-2.
Percutaneous treatment of coronary chronic total occlusions (CTOs) remains challenging, mainly due to difficulty in crossing the lesion. However tremendous progress has been achieved recently with expanded use of the retrograde approach and advanced dissection re-entry techniques. The development of the "hybrid" approach from North American operators has provided practical recommendations on how to select initial and subsequent CTO crossing strategies. Moreover, additional information has emerged on the frequency of CTOs among patients undergoing cardiac catheterization and on the adverse prognostic impact of CTOs on clinical outcomes of patients with ischemic cardiomyopathy who have implantable cardioverter defibrillators. Overall, CTO interventions remain a dynamic area with multiple novel technical and clinical developments.
经皮冠状动脉慢性完全闭塞（CTO）的治疗仍然具有挑战性，主要是因为病变部位的导丝通过比较困难。但是，最近随着逆行技术和先进的夹层再进入技术的广泛应用，已经取得了巨大的进展。北美操作者提出的“杂交”方法的发展为如何选择初始和后续 CTO 穿越策略提供了实用的建议。此外，在接受心导管检查的患者中 CTO 的发生率以及 CTO 对植入式心脏复律除颤器的缺血性心肌病患者临床结局的不良预后影响方面也出现了更多的信息。总的来说，CTO 介入仍然是一个充满活力的领域，有多个新的技术和临床发展。
