慢性完全闭塞病变的经皮冠状动脉腔内成形术(摘要)
作者：乔树宾 高润霖 陈纪林 杨跃进 姚民 秦学文 徐波 刘海波 吴永健 姚康宝
单位：北京市，中国医学科学院 中国协和医科大学 心血管病研究所 阜外心血管病医院 冠心病研究室(100037)
关键词：
中国循环杂志99zk91 目的：评价经皮冠状动脉腔内成形术(PTCA)治疗慢性完全闭塞病变的效果和安全性。
方法：至1999年7月20日止，我院共行1 655例PTCA治疗，其中慢性完全闭塞病变(CTO)(>3个月)235例(占14.2%)。235例CTO患者，其中22例选择了硬或超硬钢丝，80例(80/235)选择了中等硬度导丝，余为软钢丝(133/235)。
结果：本组完全闭塞患者中，单支血管病变为132例，双支血管病变为78例，三支血管病变为25例。CTO血管共有248处病变：前降支为133处，右冠状动脉为86处，回旋支为48处，中间动脉为1处。CTO患者中，133例有陈旧性心肌梗塞病史，147例为稳定性心绞痛。PTCA完全失败为34例，部分成功(完全闭塞未成功，但其它血管病变成功)为21例，总成功率为76.6%(180/235)。在成功的患者中，其中114例患者成功置入117个冠状动脉支架。PTCA+支架后，靶血管残余狭窄为(4.9±8.2)%。术中并发症：3例有血栓形成，4例发生冠状动脉穿孔，心室颤动，低血压，及严重冠状动脉痉挛各2例，8例发生完全闭塞，无1例发生死亡及进行急诊旁路移植手术。25例患者进行了随访造影，其中9例发生PTCA术后再狭窄，11例发生支架内再狭窄，故再狭窄率为11.1%(20/180)。其余5例无再狭窄征象。
, 百拇医药
结论：对于慢性完全闭塞病变，只要适应证选择恰当，可以取得较高的成功率，减少并发症的发生。
Outcome of Percutaneous Transluminal Coronary Angioplasty in Chronic Total Occlusion (Abstract)
Division of Coronary Heart Disease, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037)
Qiao Shubin, Gao Runlin, Chen Jilin, et al.
Objective: To evaluate the efficacy and safety of coronary angioplasty for chronic total occlusion (CTO, >3 months).
, 百拇医药
Methods: Until Jury 20, 1999, coronary angioplasty was performed in our institute for 1 655 patients. The study was based on retrospective analysis of 235 patients (14.2%) with CTO. 56.6% (133/235) of these patients were tried to canalize with floppy wires, 34.0% (80/235) with intermediate wires, 9.4% (22/235) with standard-stiffness wires. Stents weere implanted for 114 patients.
Results: One hundred thirty two patients with single-vessel disease, 78 patients with double-vessel diseases, 25 patients with triple-vessel diseases were included in this study. Target lesions of CTO (248) were as following: 113 in LAD, 86 in RCA, 48 in LCX, 1 in Ramus. 34 cases failed. 21 cases failed for CTO but successful for other lesions, success rate for the whole group was 76.6% (180/235). In-hospital complications included 3 patients with in-stent thrombosis, 4 patients with coronary artery perforation, 8 patients with abrupt occlusion. There was no death or emergency CABG. At follow-up, angiography was repeatedly performed for 25 patients. Nine patients had restenosis after PTCA, 11 patients with in-stent restenosis, restenosis rate was 11.1% (20/180). Five patients had no sign of restenosis.
Conclusion: With careful case selection, the current tools and techniques could result in higher success rate with lower complication for patients with CTO., http://www.100md.com
单位：北京市，中国医学科学院 中国协和医科大学 心血管病研究所 阜外心血管病医院 冠心病研究室(100037)
关键词：
中国循环杂志99zk91 目的：评价经皮冠状动脉腔内成形术(PTCA)治疗慢性完全闭塞病变的效果和安全性。
方法：至1999年7月20日止，我院共行1 655例PTCA治疗，其中慢性完全闭塞病变(CTO)(>3个月)235例(占14.2%)。235例CTO患者，其中22例选择了硬或超硬钢丝，80例(80/235)选择了中等硬度导丝，余为软钢丝(133/235)。
结果：本组完全闭塞患者中，单支血管病变为132例，双支血管病变为78例，三支血管病变为25例。CTO血管共有248处病变：前降支为133处，右冠状动脉为86处，回旋支为48处，中间动脉为1处。CTO患者中，133例有陈旧性心肌梗塞病史，147例为稳定性心绞痛。PTCA完全失败为34例，部分成功(完全闭塞未成功，但其它血管病变成功)为21例，总成功率为76.6%(180/235)。在成功的患者中，其中114例患者成功置入117个冠状动脉支架。PTCA+支架后，靶血管残余狭窄为(4.9±8.2)%。术中并发症：3例有血栓形成，4例发生冠状动脉穿孔，心室颤动，低血压，及严重冠状动脉痉挛各2例，8例发生完全闭塞，无1例发生死亡及进行急诊旁路移植手术。25例患者进行了随访造影，其中9例发生PTCA术后再狭窄，11例发生支架内再狭窄，故再狭窄率为11.1%(20/180)。其余5例无再狭窄征象。
, 百拇医药
结论：对于慢性完全闭塞病变，只要适应证选择恰当，可以取得较高的成功率，减少并发症的发生。
Outcome of Percutaneous Transluminal Coronary Angioplasty in Chronic Total Occlusion (Abstract)
Division of Coronary Heart Disease, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037)
Qiao Shubin, Gao Runlin, Chen Jilin, et al.
Objective: To evaluate the efficacy and safety of coronary angioplasty for chronic total occlusion (CTO, >3 months).
, 百拇医药
Methods: Until Jury 20, 1999, coronary angioplasty was performed in our institute for 1 655 patients. The study was based on retrospective analysis of 235 patients (14.2%) with CTO. 56.6% (133/235) of these patients were tried to canalize with floppy wires, 34.0% (80/235) with intermediate wires, 9.4% (22/235) with standard-stiffness wires. Stents weere implanted for 114 patients.
Results: One hundred thirty two patients with single-vessel disease, 78 patients with double-vessel diseases, 25 patients with triple-vessel diseases were included in this study. Target lesions of CTO (248) were as following: 113 in LAD, 86 in RCA, 48 in LCX, 1 in Ramus. 34 cases failed. 21 cases failed for CTO but successful for other lesions, success rate for the whole group was 76.6% (180/235). In-hospital complications included 3 patients with in-stent thrombosis, 4 patients with coronary artery perforation, 8 patients with abrupt occlusion. There was no death or emergency CABG. At follow-up, angiography was repeatedly performed for 25 patients. Nine patients had restenosis after PTCA, 11 patients with in-stent restenosis, restenosis rate was 11.1% (20/180). Five patients had no sign of restenosis.
Conclusion: With careful case selection, the current tools and techniques could result in higher success rate with lower complication for patients with CTO., http://www.100md.com