单支冠状动脉对支架内慢性完全闭塞病变再通急性结果的影响。
Influence of the Single Coronary Vessel on Acute Outcomes of In-Stent CTO Recanalization.
作者信息
Guelker Jan-Erik, Blockhaus Christian, Kemala Edward, Ingerfurth Klaus, Kuervers Julian, Bufe Alexander
机构信息
Department of Cardiology and Rhythmology, Petrus Hospital, 42283 Wuppertal, Germany.
Faculty of Health, University Witten/Herdecke, 58455 Witten, Germany.
出版信息
Rev Cardiovasc Med. 2022 Jun 29;23(7):249. doi: 10.31083/j.rcm2307249. eCollection 2022 Jul.
OBJECTIVE
Recanalization of in-stent chronic total occlusion (IS-CTO) is challenging and has resulted in inconsistent results. The aim of our study was to analyze the influence of the individual coronary vessels on the acute outcomes following IS-CTO PCI.
METHODS
This was an observational retrospective study, including 66 patients undergoing recanalization of a CTO. The CTO interventions were performed bi-femoral using 7-French guiding catheters. A composite endpoint summarizing severe complications was evaluated, including emergency coronary artery bypass grafting surgery (CABG) and cardiac death.
RESULTS
We subdivided our cohort into three groups (LAD group, LCX group, RCA group). The retrograde technique and the utilization of an extension catheter were used more frequently in patients with a RCA IS-CTO. There was no significant difference between the composite safety endpoints amongst the three groups. Technical success was independent of the involved vessel.
CONCLUSIONS
Success and complication rates are independent of the occluded vessel. This challenging and complex coronary intervention is feasible and can be carried out in complete safety.
目的
支架内慢性完全闭塞病变（IS-CTO）的再通具有挑战性，且结果不一致。我们研究的目的是分析个体冠状动脉血管对IS-CTO经皮冠状动脉介入治疗（PCI）后急性结果的影响。
方法
这是一项观察性回顾性研究，纳入66例接受CTO再通治疗的患者。CTO介入治疗采用双股动脉入路，使用7F引导导管。评估了一个总结严重并发症的复合终点，包括急诊冠状动脉旁路移植术（CABG）和心源性死亡。
结果
我们将队列分为三组（左前降支组、左旋支组、右冠状动脉组）。右冠状动脉IS-CTO患者更频繁地使用逆行技术和延长导管。三组之间的复合安全终点无显著差异。技术成功与受累血管无关。
结论
成功率和并发症发生率与闭塞血管无关。这种具有挑战性和复杂性的冠状动脉介入治疗是可行的，并且可以完全安全地进行。
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