Meng Shih-Wei, Huang Ching-Chang, Lee Chih-Kuo, Chen Chun-Kai, Yeh Chih-Fan, Chen Ying-Hsien, Lin Mao-Shin, Kao Hsien-Li
Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Rd, Taipei, 10002, Taiwan.
Sci Rep. 2022 May 4;12(1):7219. doi: 10.1038/s41598-022-10984-5.
Data on the prevalence of conus branch artery (CBA) is scarce, and its utilization in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is non-existing. The present study examined carefully in a large cohort the angiographic prevalence of CBA, its role as a collateral channel for the occlusion, and the potential usage of CBA in contemporary CTO PCI. We retrospectively examined consecutive CTO PCIs from our database between 2016 and 2019. All CTO PCIs were evaluated and the results with complications were recorded to determine the prevalence and utilization of CBA. From January 2016 to December 2019, a total of 556 CTO PCI attempts in 546 patients by high-volume operators were enrolled. The clinical, angiographic, and procedural details were collected. CBA was identifiable in 85.3% of these patients, and CBA providing visible collaterals connected to CTO distal lumen was found in 27.8% of patients. 84 CBA were used for balloon anchoring, 17 for selective distal true lumen visualization, and 9 as actual retrograde interventional collateral channel during CTO PCI. Only 1 patient suffered from chest pain during CBA balloon anchoring, and no other procedural complication such as arrhythmia or perforation occurred.CBA is frequently seen in coronary CTO. Its existence provided potential for various CTO PCI technique applications, without increase in risk.
关于圆锥支动脉（CBA）患病率的数据稀缺，且其在慢性完全闭塞病变（CTO）经皮冠状动脉介入治疗（PCI）中的应用尚不存在。本研究在一个大型队列中仔细检查了CBA的血管造影患病率、其作为闭塞侧支通道的作用以及CBA在当代CTO PCI中的潜在用途。我们回顾性研究了2016年至2019年我们数据库中连续的CTO PCI病例。对所有CTO PCI病例进行评估，并记录并发症结果，以确定CBA的患病率和利用率。2016年1月至2019年12月，共纳入了由经验丰富的术者对546例患者进行的556次CTO PCI尝试。收集了临床、血管造影和手术细节。在这些患者中，85.3%可识别出CBA，27.8%的患者发现CBA提供与CTO远端管腔相连的可见侧支。在CTO PCI期间，84条CBA用于球囊锚定，17条用于选择性远端真腔可视化，9条作为实际逆行介入侧支通道。在CBA球囊锚定期间，只有1例患者出现胸痛，未发生其他手术并发症，如心律失常或穿孔。CBA在冠状动脉CTO中经常可见。它的存在为各种CTO PCI技术应用提供了潜力，且不增加风险。
