冠状动脉慢性完全闭塞病变介入治疗的患者选择和治疗策略转化

Patient Selection and Strategy Transformation for Chronic Total Occulusion-Percutaneous Coronary Intervention

冠状动脉慢性完全闭塞(CTO)在日常造影中的检出率较高,但并不是所有CTO都需要介入治疗。由于CTO-经皮冠状动脉介入治疗(PCI)的特殊性,目前还缺少有力的临床研究证实CTO-PCI可以改善CTO患者的预后。介入治疗手段多用于改善有明确缺血证据的患者症状以及生活质量。CTO-PCI是目前PCI领域难度最大的一类手术,存在一定的失败率及并发症发生率,临床实践中应合理选择需要进行CTO-PCI的患者,根据现有的流程图制定首选策略,并在不同策略中进行安全、合理、高效的转化,从而保证手术的成功。

Chronic total occulusion(CTO)is highly detected in daily angiography,but not every CTO lesion requires interventional treatment.Due to the particularity of CTO-PCI,there is still a lack of strong clinical studies confirming that CTO-PCI can improve the prognosis of CTO patients.CTO-PCI is mostly used to improve the symptoms and quality of life of patients with clear evidence of ischemia.CTO-PCI is still the most difficult type of operation in the field of PCI,with a certain failure rate and complication rate.In clinical practice,patients who need to undergo CTO-PCI should be properly selected,and the preferred strategy should be formulated according to the contemporary algorithm and the safe,reasonable and efficient transformation of different strategies should be carried out to ensure the success of operation.