冠状动脉慢性完全闭塞病变治疗研究进展

Treatment in Patients with Coronary Chronic Total Occlusion

冠状动脉慢性完全闭塞(CTO)病变是临床中较为常见的严重冠状动脉病变。这些患者通常年龄更大,合并疾病更多。CTO病变的经皮冠脉介入术治疗难度较大,成功率相对低,且并发症的发生更多,但在经验丰富中心CTO病变经皮冠脉介入术的成功率已经达到80%~90%。CTO病变血运重建的获益目前还存在争议。观察性研究和注册研究显示,开通CTO病变可以缓解心绞痛症状,改善心功能,提高运动耐量,甚至可以减少心血管事件的发生,但是尚缺乏随机对照研究的支持。

Coronary chronic total occlusion( CTO) is a common severe coronary artery disease in clinic. These patients are older and suffer from more concurrent diseases. It is difficult to treat CTO with percutaneous coronary intervention( PCI),with a low success rate and more complications. However,the success rate of PCI for CTO in experienced medical centers has reached 80% to 90%. Now there have been controversies over the benefit of revascularization in CTO. Observational studies and registry studies have shown that the opening of CTO can help relieve the symptoms of angina,improve the cardiac function,enhance exercise tolerance and even reduce cardiovascular events,however,which lacks support from randomized controlled trials.