Dash Debabrata
Interventional Cardiologist, S. L Raheja (A Fortis Associate) Hospital, Nanavati Superspeciality Hospital, Mumbai, India; Guest Professor of Cardiology, Beijing Tiantan Hospital, Beijing, China.
Indian Heart J. 2016 Sep-Oct;68(5):737-746. doi: 10.1016/j.ihj.2016.03.009. Epub 2016 Mar 19.
Despite the continuing developments of improved medical devices and increasing operator expertize, coronary chronic total occlusion (CTO) remains as one of the most challenging lesion subsets in interventional cardiology. Percutaneous coronary intervention (PCI) of CTO is a complex procedure carrying the risk of complications that are responsible for significant morbidity and mortality. The complications can be classified as coronary (such as coronary occlusion, perforation, device embolization, or entrapment); cardiac non-coronary (such as periprocedural myocardial infarction); extra cardiac (such as vascular access complications, systemic embolization, contrast-induced nephropathy, and radiation-induced injury). Further, certain complications (such as donor vessel dissection or thrombosis) are unique to CTO-PCI. There are also complications related to specialized techniques, such as dissection/reentry and retrograde crossing techniques. A thorough understanding of the potential complications is critical to mitigate risk during these complex procedures.
尽管医疗设备不断改进，操作人员的专业技能也日益提高，但冠状动脉慢性完全闭塞（CTO）仍然是介入心脏病学中最具挑战性的病变亚组之一。CTO的经皮冠状动脉介入治疗（PCI）是一种复杂的手术，存在并发症风险，这些并发症会导致显著的发病率和死亡率。并发症可分为冠状动脉性（如冠状动脉闭塞、穿孔、器械栓塞或卡压）；心脏非冠状动脉性（如围手术期心肌梗死）；心脏外（如血管通路并发症、系统性栓塞、造影剂肾病和辐射损伤）。此外，某些并发症（如供体血管夹层或血栓形成）是CTO-PCI所特有的。还有与特殊技术相关的并发症，如夹层/再入和逆行通过技术。全面了解潜在并发症对于降低这些复杂手术的风险至关重要。
