Rahman Mohammed Shamim, de Winter Ruben, Nap Alex, Knaapen Paul
Department of Cardiology, Birmingham City Hospital, SWBH NHS Trust Birmingham, UK.
Department of Cardiology, Amsterdam Medical Centre, VU Medical Centre Amsterdam, the Netherlands.
Interv Cardiol. 2021 Dec 24;16:e33. doi: 10.15420/icr.2021.12. eCollection 2021 Apr.
Revascularisation of chronic total occlusion (CTO) represents one of the most challenging aspects of percutaneous coronary intervention, but advances in equipment and an understanding of CTO revascularisation techniques have resulted in considerable improvements in success rates. In patients with prior coronary artery bypass grafting (CABG) surgery, additional challenges are encountered. This article specifically explores these challenges, as well as antegrade methods of CTO crossing. Techniques, equipment that can be used and reference texts are highlighted with the aim of providing potential CTO operators adequate information to tackle additional complexities likely to be encountered in this cohort of patients. This review forms part of a wider series where additional aspects of patients with prior CABG should be factored into decisions and methods of revascularisation.
慢性完全闭塞病变（CTO）的血管重建是经皮冠状动脉介入治疗中最具挑战性的方面之一，但设备的进步以及对CTO血管重建技术的理解已使成功率有了显著提高。对于既往接受过冠状动脉旁路移植术（CABG）的患者，会遇到更多挑战。本文专门探讨这些挑战以及CTO正向通过的方法。文中重点介绍了相关技术、可使用的设备和参考文献，旨在为潜在的CTO手术操作者提供足够的信息，以应对该类患者群体可能遇到的额外复杂性。本综述是一个更广泛系列的一部分，在血管重建的决策和方法中应考虑既往接受CABG患者的其他方面。
