[1]郭云飞 柳景华.冠状动脉慢性完全闭塞合并分叉病变介入治疗[J].心血管病学进展,2020,(1):7-10.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.003]
 GUO Yunfei,LIU Jinghua.Percutaneous Coronary Intervention for Chronic Total Occlusion with Bifurcation Lesions[J].Advances in Cardiovascular Diseases,2020,(1):7-10.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.003]
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冠状动脉慢性完全闭塞合并分叉病变介入治疗()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年1期
页码:
7-10
栏目:
综述
出版日期:
2020-02-04

文章信息/Info

Title:
Percutaneous Coronary Intervention for Chronic Total Occlusion with Bifurcation Lesions
作者:
郭云飞1 柳景华2
(1.北京市海淀医院心血管内科,北京 100080;2.首都医科大学附属北京安贞医院心血管内科,北京 100029)
Author(s):
GUO Yunfei1LIU Jinghua2
(1.Department of Cardiology,Haidian Hospital,Beijing 100080,China; 2.Department of Cardiology,Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing 100080,China)
关键词:
慢性完全闭塞病变分叉病变经皮冠脉介入术主要心脏不良事件
Keywords:
Chronic total occlusionBifurcation lesionsPercutaneous coronary interventionMajor adverse cardiac events
DOI:
10.16806/j.cnki.issn.1004-3934.2020.01.003
摘要:
慢性完全闭塞病变成为经皮冠脉介入术治疗“最后的堡垒”。成功开通闭塞病变,可改善心绞痛症状、生活质量、左室射血分数和远期预后。慢性闭塞合并分叉病变时,介入治疗操作更复杂。随着各种正向/逆向技术发展和新型器械的应用,闭塞血管开通率逐渐提升,但分支闭塞风险仍较高。分支闭塞导致围手术期心肌梗死和主要心脏不良事件升高。慢性闭塞合并分叉病变介入治疗过程中容易出现冠状动脉夹层、假腔,影响分支血流。使介入手术难度增加,成功率降低和并发症增多。
Abstract:
Chronic total occlusion(CTO) of coronary artery becomes the "last bastion" of percutaneous coronary intervention. Successful opening of chronic obstructive diseases can effectively improve angina symptoms, quality of life, left ventricular ejection fraction and long-term prognosis. I f chronic occlusion of coronary artery is accompanied with bifurcation lesions, the operation of interventional therapy is quite complex. With the development of various forward/reverse techniques and the application of new equipment, the opening rate of occluded vessels is increase d gradually, but the risk of side branch occlusion is still high. Bifurcation occlusion leads to increased perioperative myocardial infarction and major adverse cardiac events. CTO with BL is prone to coronary dissection and pseudolumen during interventional procedure, which affects the branch blood flow,and it increased t he difficulty of interventional surgery, reduced the success rate and increased the complications.

参考文献/References:

[1] 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.

[2]R?munddal T,Hoebers LP,Henriques JP,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.

[3] 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.

[4]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.

[5]Galassi AR,Boukhris M,Tomasello SD,et al.Incidence, treatment and in-hospital outcome of bifurcation lesions in patients undergoing percutaneous coronary interventions for chronic total occlusions[J].Coron Artery Dis,2015,26(2):142-149.

[6]Ojeda S,Azzalini L,Chavarría J,et al. One versus 2-stent strategy for the treatment of bifurcation lesions in the context of a coronary chronic total occlusion. A multicenter registry[J]. Rev Esp Cardiol(Engl Ed),2017,71(5):344-350.

[7]Chen SL,Ye F,Zhang JJ,et al.Clinical outcomes after recanalization of a chronic total occluded vessel with bifurcation lesions:results from single-center, prospective, chronic total occlusion registry study[J]. Chin Med J,2012,125(6):1035-1040.

[8] Ojeda S,Pan M ,Gutierrez-Barrios A,et al.Bifurcation lesions involved in the recanalization process of coronary chronic total occlusions:incidence, treatment and clinical implications[J]. Int J Cardiol,2017,230:432-438.

[9] Sachdeva R,Agrawal M,Flynn SE,et al. Reversal of ischemia of donor artery myocardium after recanalization of a chronic total occlusion[J]. Catheter Cardiovasc Interv,2013,82(4):E453-458.

[10]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.

[11]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,2015,117(5):720-726.

[12] Azzalini L,Torregrossa G,Puskas JD,et al. Percutaneous revascularization of chronic total occlusions:rationale,indications,techniques, and the cardiac surgeon’s point of view[J].Int J Cardiol,2017,231:90-96.

[13]Azzalini L,Candilio L,Ojeda S,et al. Impact of incomplete revascularization on long-term outcomes following chronic total occlusion percutaneous coronary intervention[J]. Am J Cardiol,2018,121(10):1138-1148.

[14]Nombela-Franco L,Iannaccone M,Anguera I,et al. Impact of chronic total coronary occlusion on recurrence of ventricular arrhythmias in ischemic secondary prevention implantable cardioverter-defibrillator recipients (VACTO secondary study): insights from coronary angiogram and electrogram analysis[J]. JACC Cardiovasc Interv,2017,10(9):879-888.

[15]Jang WJ,Yang JH,Choi SH,et al.Long-term survival benefit of revascularization compared with medical therapy in patients with coronary chronic total occlusion and well-developed collateral circulation[J]. JACC Cardiovasc Interv,2015,8(2):271-279.

[16] Galassi AR,Werner GS,Boukhris M,et al.Percutaneous Recanalization of Chronic Total Occlusions:2019 Consensus Document from the EuroCTO Club [J]. EuroIntervention,2019,15(2):198-208

[17]Galassi AR,Brilakis ES,Boukhris M,et al. Appropriateness of percutaneous revascularization of coronary chronic total occlusions:an overview[J]. Eur Heart J,2016,37(35):2692-2700.

[18] Hahn JY ,Chun WJ,Kim JH,et al. Predictors and outcomes of side branch occlusion after main vessel stenting in coronary bifurcation lesions:results from the COBIS Ⅱ Registry (COronary BIfurcation Stenting)[J]. J Am Coll Cardiol,2013,62(18):1654-1659.

[19]Nairooz R,Saad M,Elgendy IY,et al. Long-term outcomes of provisional stenting compared with a two-stent strategy for bifurcation lesions:a meta-analysis of randomised trials[J]. Heart,2017,103(18):1427-1434.

[20]Maeng M,Holm NR,Erglis A,et al.Long-term results after simple versus complex stenting of coronary artery bifurcation lesions:Nordic Bifurcation Study 5-year follow-up results[J]. J Am Coll Cardiol,2013,62(1):30-34.

[21]Ferenc M,Ayoub M,Buttner HJ,et al. Long-term outcomes of routine versus provisional T-stenting for de novo coronary bifurcation lesions:five-year results of the Bifurcations Bad Krozingen I study[J]. EuroIntervention,2015,11(8):856-859.

[22]Kim YH,Lee JH,Roh JH,et al. Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis[J].JACC Cardiovasc Interv,2015,8:550-560.

[23] Trine ?,Niels R H,Troels M N,et al.Randomized comparison of provisional side branch stenting versus a two-stent strategy for treatment of true coronary bifurcation lesions involving a large side branch. Two-year results in the Nordic-Baltic bifurcation study IV[J]. JACC,2014,64(11):B54.

[24] Ermi? E 1,U?ar H,Demirelli S,et al.Assessment of side branch patency using a jailed semi-inflated balloon technique with coronary bifurcation lesions[J].Turk Kardiyol Dern Ars,2018,46(5):340-348

[25]Oreglia JA,Garbo R,Gagnor A,et al.Dual lumen microcatheters for complex percutaneous coronary interventions[J]. Cardiovasc Revasc Med,2018,19(3 Pt A):298-305.

[26]Nguyen-Trong PK,Rangan BV,Karatasakis A,et al. Predictors and outcomes of side-branch occlusion in coronary chronic total occlusion interventions[J]. J Invasive Cardiol,2016,28(4):168-173.

[27] Spaziano M,Roy A,Akodad M,et al. Five-year outcomes of bifurcation stenting: insights from the SYNTAX trial[J]. Eur Heart J,2017,38:443-444.

[28] Chen SL,Santoso T,Zhang JJ,et al. Clinical outcome of double kissing crush versus provisional stenting of coronary artery bifurcation lesions:the 5-year follow-up results from a randomized and multicenter DKCRUSH-Ⅱstudy(Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions)[J]. Circ Cardiovasc Interv,2017,10(2). pii:e004497

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备注/Memo

备注/Memo:
通讯作者:郭云飞,E-mail:13520234261@163.com
更新日期/Last Update: 2020-03-23