Guelker J E, Rock T, Ott R, Katoh M, Kroeger K, Guelker R, Klues H G, Shin D I, Bufe A
Helios Clinic Krefeld, Department of Cardiology, Heartcentre Niederrhein, Germany.
Helios Clinic Krefeld, Department of Diagnostic and Interventional Radiology, Germany.
Med J Malaysia. 2017 Aug;72(4):236-240.
Percutaneous coronary intervention (PCI) of total chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. There is only insignificant knowledge reported in the literature about age differences in CTO recanalization. We analyzed in this study the issue of the impact of age on procedural characteristics, complications and short-term outcome.
Between 2012-2016 we included 440 patients. They underwent PCI for at least one CTO. Antegrade and retrograde CTO techniques were applied. The retrograde approach was used only after failed antegrade intervention. Continuous data are presented as the mean ± standard deviation; categorical data are presented as numbers and percentages unless otherwise specified. We used Twosamplet- t-test with equal variance to test the significant differences of the variables between the two cohorts.
Procedural success proved independently of age. There was no significant interaction between age and procedural success (p=0.5). Complication rates were low in both groups (2.7% vs. 4%; p=0,4) with no difference in statistical significance.
Our study suggests that in an aging society patients with severe coronary artery disease and chronical total occlusions an interventional therapy should be used more intensively. It can be performed safe and feasible.
完全慢性闭塞病变（CTO）的经皮冠状动脉介入治疗（PCI）仍是介入心脏病学中的一项重大挑战。关于CTO再通的年龄差异，文献中报道的知识很少。我们在本研究中分析了年龄对手术特征、并发症和短期预后的影响问题。
在2012年至2016年期间，我们纳入了440例患者。他们接受了至少一次CTO的PCI治疗。应用了正向和逆向CTO技术。仅在正向干预失败后才使用逆向方法。连续数据以平均值±标准差表示；分类数据以数字和百分比表示，除非另有说明。我们使用具有相等方差的双样本t检验来检验两个队列之间变量的显著差异。
手术成功与否与年龄无关。年龄与手术成功之间没有显著的相互作用（p = 0.5）。两组的并发症发生率都很低（2.7%对4%；p = 0.4），在统计学意义上没有差异。
我们的研究表明，在老龄化社会中，对于患有严重冠状动脉疾病和慢性完全闭塞的患者，应更积极地使用介入治疗。它可以安全可行地进行。
