冠状动脉慢性完全闭塞病变开通后支架内慢性完全闭塞病变经皮冠状动脉介入治疗效果及失败原因分析

Effect and Failure Reasons of Percutaneous Coronary Intervention on In-stent Chronic Total Occlusion after Recanalization of Chronic Total Occlusion

目的探讨冠状动脉慢性完全闭塞病变开通后支架内慢性完全闭塞（ISCTO）经皮冠状动脉介入治疗（PCI）的效果及失败原因。方法选取2011年12月-2012年12月浙江大学医学院附属第二医院心内科收治的ISCTO患者20例，其均行PCI，观察患者疗效。结果PCI成功14例，成功率为70％；失败6例。无严重并发症发生。结论对ISCTO患者行PCI是安全有效的，治疗失败主要原因可能与影像学血管闭塞特点、闭塞时间长短、ISCTO的病理特点和病变难点有关。

Objective To explore the effect and failure reasons of percutaneous coronary intervention( PCI) on in-stent chronic total occlusion( ISCTO) after recanalization of chronic total occlusion. Methods 20 patients with ISCTO admitted to the Second Affiliated Hospital of Zhejiang Medical University from December 2011 to December 2012 were treated by PCI. The effect was observed. Results 14 patients were treated successfully,the incidence of success was 70%; 6 patients were treated unsuccessfully. No serious complication was occurred. Conclusion PCI in treating ISCTO patients is safe and effective. The characteristics of imaging occlusion lesions,persisting time of occlusion lesions,pathological features and difficulties of ISCTO are failure reasons of intervention treatment.