[1]董佳佳 于子翔 马依彤.冠状动脉慢性完全闭塞病变血运重建的治疗[J].心血管病学进展,2020,(8):794-797.[doi:10.16806/j.cnki.issn.1004-3934.2020.08.003]
 DONG Jiajia,YU Zixiang,MA Yitong.Therapeutic Strategy of Revascularization in Patients with Chronic Complete Occlusion[J].Advances in Cardiovascular Diseases,2020,(8):794-797.[doi:10.16806/j.cnki.issn.1004-3934.2020.08.003]
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冠状动脉慢性完全闭塞病变血运重建的治疗()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年8期
页码:
794-797
栏目:
综述
出版日期:
2020-08-25

文章信息/Info

Title:
Therapeutic Strategy of Revascularization in Patients with Chronic Complete Occlusion
作者:
董佳佳 于子翔 马依彤
(新疆医科大学第一附属医院心脏中心冠心病一科,新疆 乌鲁木齐 830054)
Author(s):
DONG Jiajia YU Zixiang MA Yitong
(Department of coronary heart disease, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830054)
关键词:
冠状动脉慢性完全闭塞血运重建治疗策略
Keywords:
Coronary c hronic total occlusion Revascularization Treatment strategies
DOI:
10.16806/j.cnki.issn.1004-3934.2020.08.003
摘要:
冠状动脉慢性完全闭塞性病变(CTO)占所有冠心病患者的15%~25%,在观察到的CTO患者中,只有相对少的一部分完成了血运重建。随着技术和设备的进步,CTO血运重建的成功率得到了很大的提高,同时减少了并发症。最近关于CTO血运重建的临床益处的证据越来越多,特别是在缓解心绞痛方面得到了证实。然而,不同研究之间的结果仍存在异质性,对于CTO是否需要血运重建目前存在较大争议。现就CTO的血运重建的理论依据、CTO治疗策略的选择、临床获益情况及全球专家共识等方面进行阐述。
Abstract:
Coronary chronic total occlusion (CTO) accounts for about 15% to 25% of all patients with coronary heart disease, and only a relatively small part of the CTO patients have completed revascularization. With the development of technology and equipment , the success rate of CTO revascularization has been greatly improved and complications have been reduced. Recently , there ha ve more and more evidence s about the clinical benefits of CTO revascularization , especially in relieving angina. However , the results of different studies are still heterogeneous , and there is a big controversy about whether CTO needs revascularization.?This article gives a brief introduction to the theoretical basis of CTO revascularization , the choice of CTO treatment strategies , clinical benefits and the consensus of global experts.

参考文献/References:


[1] Di Mario C,Werner GS,Sianos Get al. European perspective in the recanalisation of Chronic Total Occlusions (CTO):consensus document from the EuroCTO Club[J]. EuroIntervention,2007,3(1):30-43.

[2] Sianos G,Werner GS,Galassi AR,et al. Recanalisation of chronic total coronary occlusions:2012 consensus document from the EuroCTO club[J]. EuroIntervention,2012,8(1):139-145.

[3] Karmpaliotis D,Karatasakis A,Alaswad K,et al. Outcomes with the use of the retrograde approach for coronary chronic total occlusion interventions in a contemporary multicenter US Registry[J]. Circ Cardiovasc Interv,2016,9(6):10.1161/CIRCINTERVENTIONS.115.003434 e003434.

[4] Tomasello SD,Boukhris M,Giubilato S,et al. Management strategies in patients affected by chronic total occlusions:results from the Italian Registry of Chronic Total Occlusions[J]. Eur Heart J,2015,36(45):3189-3198.

[5] R?munddal T,Hoebers LP,Hoebers L,et al. Chronic total occlusions in Sweden—A report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)[J]. PLoS One,2014,9(8):e103850.

[6] Claessen BE,van der Schaaf RJ,Verouden NJ,et al. Evaluation of the effect of a concurrent chronic total occlusion on long-term mortality and left ventricular function in patients after primary percutaneous coronary intervention[J]. JACC Cardiovasc Interv,2009,2(11):1128-1134.

[7] Azzalini L,Vo M,Dens J,et al. Myths to debunk to improve management,referral,and outcomes in patients with chronic total occlusion of an epicardial coronary artery[J]. Am J Cardiol,2015,116(11):1774-1780.

[8] Safley DM,Koshy S,Grantham JA,et al. Changes in myocardial ischemic burden following percutaneous coronary intervention of chronic total occlusions[J]. Catheter Cardiovasc Interv,2011,78(3):337-343.

[9] Rossello X,Pujadas S,Serra A,et al. Assessment of inducible myocardial ischemia,quality of life,and functional status after successful percutaneous revascularization in patients with chronic total coronary occlusion[J]. Am J Cardiol,2016,117(5):720-726.

[10] Safley DM,Grantham JA,Hatch J,et al. Quality of life benefits of percutaneous coronary intervention for chronic occlusions[J]. Catheter Cardiovasc Interv,2014,84(4):629-634.

[11] Galassi AR,Werner GS,Boukhris M,et al. Percutaneous recanalisation of chronic total occlusions:2019 consensus document from the EuroCTO Club[J]. EuroIntervention,2019,15(2):198-208.

[12] Azzalini L,Jolicoeur EM,Pighi M,et al. Epidemiology,Management Strategies,and Outcomes of Patients With Chronic Total Coronary Occlusion[J]. Am J Cardiol,2016,118(8):1128-1135.

[13] Bhatnagar UB,Shrestha A,Petrasko M,et al. Current evidence and rationale of percutaneous therapy for chronic total coronary occlusions[J]. Curr P robl C ardiol,2019,44(12):100412.

[14] 白海渊,脱军运,王志禄.冠状动脉慢性完全闭塞病变的临床研究进展[J]. 中华老年心脑血管病杂志,2015,17(9):990-993.

[15] 安明春,杨旭明.冠状动脉慢性完全闭塞病变介入治疗及临床获益研究进展[J]. 心血管病学进展,2019,40(6):860-864.

[16] Neumann FJ,Sousa-Uva M,Ahlsson A,et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. The Task Force on myocardial revascularization of the European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS)[J]. G Ital Cardiol (Rome).,2019,20(7-8 Suppl 1):1S-61S.

[17] Christakopoulos GE,Christopoulos G,Carlino M,et al. Meta-analysis of clinical outcomes of patients who underwent percutaneous coronary interventions for chronic total occlusions[J]. Am J Cardiol,2015,115(10):1367-1375.

[18] Lee PH,Lee SW,Park HS,et al. Successful recanalization of native coronary chronic total occlusion is not associated with improved long-term survival[J]. JACC Cardiovasc Interv,2016,9(6):530-538.

[19] Werner GS,Martin-Yuste V,Hildick-Smith D,et al. A randomized multicentre trial to compare revascularization with optimal medical therapy for the treatment of chronic total coronary occlusions[J]. Eur Heart J,2018,39(26):2484-2493.

[20] Henriques JP,Hoebers LP,R?munddal T,et al. Percutaneous Intervention for Concurrent?Chronic Total Occlusions in?Patients With?STEMI:The EXPLORE Trial[J]. J Am Coll Cardiol,2016,68(15):1622-1632.

[21] Sachdeva R,Agrawal M,Flynn SE,et al. The myocardium supplied by a chronic total occlusion is a persistently ischemic zone[J]. Catheter Cardiovasc Interv,2014,83(1):9-16.

[22] Werner GS,Ferrari M,Heinke S,et al. Angiographic assessment of collateral connections in comparison with invasively determined collateral function in chronic coronary occlusions[J]. Circulation,2003,107(15):1972-1977.

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备注/Memo

备注/Memo:
基金项目:新疆维吾尔自治区自然科学基金青年基金(2017D01C348)
通信作者:马依彤,myt-xj@163.com
收稿日期:2020-02-08
更新日期/Last Update: 2020-11-02