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辅助手段在冠状动脉慢性完全闭塞病变介入治疗中的应用价值

Utility of adjunctive modalities in Coronary chronic total occlusion intervention.

作者信息

Bhatt Hemal, Janzer Sean, George Jon C

机构信息

Division of Cardiovascular Disease, Department of Internal Medicine, Einstein Medical Center, Philadelphia, PA 19141, USA.

Division of Cardiovascular Disease, Department of Internal Medicine, Einstein Medical Center, Philadelphia, PA 19141, USA.

出版信息

Indian Heart J. 2017 May-Jun;69(3):375-381. doi: 10.1016/j.ihj.2017.02.015. Epub 2017 Feb 24.

DOI:10.1016/j.ihj.2017.02.015
PMID:28648437
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5485396/
Abstract

Coronary chronic total occlusion (CTO) intervention remains one of the most challenging domains in interventional cardiology. Due to the technical challenges involved and potential procedural complications, CTO percutaneous coronary intervention (PCI) attempt and success rates remain less than standard PCI. However, the use of several adjunctive tools such as intravascular ultrasound, optical coherence tomography, rotational atherectomy, orbital atherectomy, excimer laser coronary atherectomy and percutaneous left ventricular assist device may contribute to improved CTO PCI success rates or provide better hemodynamic assessment of CTO lesion (i.e., using fractional flow reserve). In this review we present the current literature describing the utility and efficacy of these adjunctive modalities in CTO intervention.

摘要

冠状动脉慢性完全闭塞（CTO）介入治疗仍然是介入心脏病学中最具挑战性的领域之一。由于涉及技术挑战和潜在的手术并发症，CTO经皮冠状动脉介入治疗（PCI）的尝试率和成功率仍低于标准PCI。然而，使用血管内超声、光学相干断层扫描、旋磨术、轨道旋切术、准分子激光冠状动脉斑块旋切术和经皮左心室辅助装置等几种辅助工具，可能有助于提高CTO PCI成功率或对CTO病变进行更好的血流动力学评估（即使用血流储备分数）。在本综述中，我们介绍了描述这些辅助方法在CTO介入治疗中的效用和疗效的当前文献。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a9/5485396/bd4a41d72ae7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a9/5485396/60262ef3e065/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a9/5485396/90c13dd694c8/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a9/5485396/b2ced3d6daed/gr5.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a9/5485396/e15a349bde78/gr7.jpg

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本文引用的文献

1
Language of CTO interventions - Focus on hardware.慢性完全闭塞病变介入治疗的语言——聚焦于硬件
Indian Heart J. 2016 Jul-Aug;68(4):450-63. doi: 10.1016/j.ihj.2016.06.015. Epub 2016 Jul 2.
2
Guidewire crossing techniques in coronary chronic total occlusion intervention: A to Z.冠状动脉慢性完全闭塞病变介入治疗中的导丝通过技术：从A到Z
Indian Heart J. 2016 May-Jun;68(3):410-20. doi: 10.1016/j.ihj.2016.02.019. Epub 2016 Mar 14.
3
Percutaneous Coronary Intervention in Severely Calcified Unprotected Left Main Coronary Artery Disease: Initial Experience With Orbital Atherectomy.
严重钙化无保护左主干冠状动脉疾病的经皮冠状动脉介入治疗：轨道旋磨术的初步经验
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Percutaneous Mechanical Circulatory Support for Cardiogenic Shock.用于心源性休克的经皮机械循环支持
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Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease (FAME): 5-year follow-up of a randomised controlled trial.多支冠状动脉疾病患者经皮冠状动脉介入治疗中血流储备分数与血管造影指导的比较（FAME）：一项随机对照试验的 5 年随访结果。
Lancet. 2015 Nov 7;386(10006):1853-60. doi: 10.1016/S0140-6736(15)00057-4. Epub 2015 Aug 30.
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Clinical Impact of Intravascular Ultrasound-Guided Chronic Total Occlusion Intervention With Zotarolimus-Eluting Versus Biolimus-Eluting Stent Implantation: Randomized Study.血管内超声引导下佐他莫司洗脱支架与生物雷帕霉素洗脱支架植入治疗慢性完全闭塞病变的临床影响：随机研究
Circ Cardiovasc Interv. 2015 Jul;8(7):e002592. doi: 10.1161/CIRCINTERVENTIONS.115.002592.
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European expert consensus on rotational atherectomy.欧洲旋切术专家共识。
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8
Collateral donor artery physiology and the influence of a chronic total occlusion on fractional flow reserve.侧支供血动脉生理学及慢性完全闭塞对血流储备分数的影响。
Circ Cardiovasc Interv. 2015 Apr;8(4). doi: 10.1161/CIRCINTERVENTIONS.114.002219.
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Procedural outcomes of chronic total occlusion percutaneous coronary intervention: a report from the NCDR (National Cardiovascular Data Registry).慢性完全闭塞经皮冠状动脉介入治疗的操作结果：来自 NCDR（国家心血管数据注册中心）的报告。
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Atherectomy devices: technology update.旋切术器械：技术更新
Med Devices (Auckl). 2014 Dec 17;8:1-10. doi: 10.2147/MDER.S50594. eCollection 2015.