摘要冠状动脉慢性完全闭塞(chronic total occlusion,CTO)指冠状动脉出现严重的"粥样硬化"性病变,导致冠状动脉斑块负荷过重,造影显示冠状动脉近乎100%闭塞,成为目前冠状动脉疾病介入领域的重点和难点。CTO闭塞病变时间至少在3个月以上,国外研究示冠状动脉造影中有30%以上提示为CTO病变,
1Joseph P,Michael S,James T,et al.The natural history of single-vessel chronic coronary occlusion:A 25-year experience[J].Am Heart J,1997,133(4):393-399.
2Kinoshitaw I,Katoh O,Nariyama J,et al.Coronary angioplasty of chronic total occlusions with bridging collateral vessels:Immediate and follow-up outcome from a large single center experience[J].J Am Coll Cardiol,1995,26(2):409.
3Kandzari DE.The challenges of chronic total coronary occlusions:An old problem in a new perspective[J].J Interv Cardiol,2004,17(4):259-267.
4Sharma SK,Chen V.Coronary interventional devices:Balloon,atherectomy,thrombectomy and distal protection devices[J].Cardiol Clin,2006,24(2):201-215.
5Ochiai M,Ashida K,Araki H,et al.The latest wire technique for chronic total occlusion[J].Ital Heart J,2005,6(6):489-493.
6Ozawa A.A new understanding of chronic total occlusion from a novel PCI technique that involves a retrograde approach to the right coronary artery via a septal branch and passing of the guidewire to a guiding catheter on the other side of the lesion[J].Catheter Cardiovasc Interv,2006,68(6):907-913.
7Brilakis ES, Grantham JA, Rinfret S, et al. A percutaneous treatment algorithm for crossing coronary chronic total occlusions. JACC Cardiovasc Interv ,2012,5:367-379.
8Werner GS, Ferrari M, Heinke S, et al. Angiographic assessment of collateral connections in comparison with invasively determined collateral function in chronic coronary occlusions. Circulation, 2003, 107 : 1972-1977.
9Di Mario C, Werner GS, Sianos G, et al. European perspective in the recanalisation of chronic total occlusions ( CTO ) : consensus document from the EuroCTO Club. EuroIntervention, 2007,3 : 30- 43.
10Nakamura S, Muthusamy TS, Bae JH, et al. Impact of sirolimus- eluting stent on the outcome of patients with chronic total occlusions. Am J Cardio1,2005 ,95 :161-166.