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冠状动脉慢性完全闭塞病变介入治疗：病理生理学视角

Coronary chronic total occlusion intervention: A pathophysiological perspective.

作者信息

Dash Debabrata

机构信息

Thumbay Hospital, Ajman, United Arab Emirates; Beijing Tiantan Hospital, Beijing, China.

出版信息

Indian Heart J. 2018 Jul-Aug;70(4):548-555. doi: 10.1016/j.ihj.2018.01.021. Epub 2018 Jan 10.

DOI:10.1016/j.ihj.2018.01.021
PMID:30170652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6116719/
Abstract

Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) is the last frontier in coronary intervention. PCI of CTO carries multiple advantages, such as significant improvement in symptoms, improvement in abnormal wall motion and left ventricular function and, possibly, increased long-term survival. As of today the procedural success is markedly improved because of technical innovations and is limited to highly experienced operators. To enhance the overall success rate from a worldwide perspective, a thorough understanding of its pathophysiology is critical to further development of newer techniques and technologies. In this review, the author outlines in-depth the evidence that underpins our understanding of CTO pathophysiology and its insight into CTO intervention that incorporates various steps and techniques to cross the lesion.

摘要

慢性完全闭塞病变（CTO）的经皮冠状动脉介入治疗（PCI）是冠状动脉介入治疗的最后一个前沿领域。CTO的PCI具有多种优势，如症状显著改善、异常室壁运动和左心室功能改善，以及可能提高长期生存率。截至目前，由于技术创新，手术成功率显著提高，但仅限于经验丰富的术者。从全球角度提高总体成功率，深入了解其病理生理学对于新技术和技术的进一步发展至关重要。在这篇综述中，作者深入概述了支撑我们对CTO病理生理学理解的证据，以及其对CTO介入治疗的见解，该治疗纳入了跨越病变的各种步骤和技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/567e19f7d9ae/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/9ab25d4d414c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/acdf875bc008/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/d74a3327843c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/4636b246b22f/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/567e19f7d9ae/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/9ab25d4d414c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/acdf875bc008/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/d74a3327843c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/4636b246b22f/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d045/6116719/567e19f7d9ae/gr5.jpg

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本文引用的文献

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Problems encountered in retrograde recanalization of coronary chronic total occlusion: Should we lock the backdoor in 2018?冠状动脉慢性完全闭塞病变逆向开通中遇到的问题：2018年我们是否应关闭“后门”？
Indian Heart J. 2018 Jan-Feb;70(1):132-134. doi: 10.1016/j.ihj.2017.11.014. Epub 2017 Nov 21.
2
Chronic total occlusions - Current techniques and future directions.慢性完全闭塞病变——当前技术与未来方向
Int J Cardiol Heart Vasc. 2015 Feb 7;7:28-39. doi: 10.1016/j.ijcha.2015.02.002. eCollection 2015 Jun 1.
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Unraveling the mystique of CTO Interventions: Tips and techniques of using hardware to achieve success.
经皮冠状动脉介入治疗对慢性完全性冠状动脉阻塞患者生物标志物及生活质量的影响
Cardiol Res. 2023 Feb;14(1):69-78. doi: 10.14740/cr1455. Epub 2023 Feb 25.
4
A Novel Classification for Predicting Chronic Total Occlusion Percutaneous Coronary Intervention.一种用于预测慢性完全闭塞性经皮冠状动脉介入治疗的新型分类方法。
Front Cardiovasc Med. 2022 Feb 28;9:762351. doi: 10.3389/fcvm.2022.762351. eCollection 2022.
5
Lesion characteristics and procedural complications of chronic total occlusion percutaneous coronary intervention in patients with prior bypass surgery: A meta-analysis.既往旁路移植术后患者慢性完全闭塞经皮冠状动脉介入治疗的病变特征和操作并发症：一项荟萃分析。
Clin Cardiol. 2022 Jan;45(1):18-30. doi: 10.1002/clc.23766. Epub 2022 Jan 6.
6
Impact of chronic total occlusion lesion length on six-month angiographic and 2-year clinical outcomes.慢性完全闭塞病变长度对 6 个月血管造影和 2 年临床结果的影响。
PLoS One. 2018 Nov 13;13(11):e0198571. doi: 10.1371/journal.pone.0198571. eCollection 2018.
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Int J Cardiovasc Imaging. 2018 Nov;34(11):1813-1818. doi: 10.1007/s10554-018-1392-3. Epub 2018 Jun 8.
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Retrograde Coronary Chronic Total Occlusion Intervention.逆向冠状动脉慢性完全闭塞病变介入治疗
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