Hennepin County Medical Center, Department of Cardiovascular Medicine, Minneapolis, MN, USA.
Hennepin County Medical Center, Department of Cardiovascular Medicine, Minneapolis, MN, USA; Hennepin County Medical Center, Department of Internal Medicine, Minneapolis, MN, USA.
Prog Cardiovasc Dis. 2021 Nov-Dec;69:27-34. doi: 10.1016/j.pcad.2021.11.004. Epub 2021 Nov 23.
Chronic total occlusion (CTO) percutaneous coronary interventions (PCI) can be challenging to perform. The main indication for CTO PCI is to improve symptoms. Several contemporary studies have reported high CTO PCI success rates at experienced centers but success rates in all-comer registries remain low. Several scores can estimate the difficulty and the likelihood of success of CTO PCI. Dual arterial access and use of CTO crossing algorithms can improve the success and safety of CTO PCI. Intracoronary imaging can optimize stent expansion and minimize adverse cardiovascular events. While complications are more common in CTO PCI, careful planning and prompt diagnosis and treatment can prevent them or minimize their adverse consequences. In this article, we review contemporary data on the indications, safety and efficacy of CTO PCI.
慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）可能具有挑战性。CTO PCI 的主要适应证是改善症状。几项当代研究报告了在经验丰富的中心进行 CTO PCI 的高成功率，但所有患者登记处的成功率仍然较低。有几种评分系统可以评估 CTO PCI 的难度和成功率。双动脉入路和 CTO 交叉算法的使用可以提高 CTO PCI 的成功率和安全性。冠状动脉内影像学可以优化支架扩张，最大限度地减少不良心血管事件。虽然 CTO PCI 的并发症更为常见，但仔细的规划以及及时的诊断和治疗可以预防或最大限度地减少其不良后果。在本文中，我们回顾了 CTO PCI 的适应证、安全性和疗效的当代数据。
