冠状动脉慢性完全闭塞病变病理生理机制和血运重建策略
沈卫峰,沈迎,丁风华,张瑞岩
摘要(Abstract):
<正>冠状动脉慢性完全闭塞(chronic total occlusion,CTO)是指冠状动脉管腔100%闭塞、前向TIMI血流0级,且持续时间3个月以上(少数情况下,同侧桥侧支形成,使阻塞远端TIMI血流>0级,也属CTO范畴)。冠状动脉造影证实冠心病患者中,约20%存在CTO[1]。CTO病变已成为经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)领域中需要
关键词(KeyWords): 慢性完全闭塞;血运重建
基金项目(Foundation): 上海交通大学医工交叉基金(GY2016MS66);上海交通大学科技创新基金(17XJ11009)
作者(Author): 沈卫峰,沈迎,丁风华,张瑞岩
参考文献(References):
- [1]中国冠状动脉慢性完全闭塞病变介入治疗俱乐部.中国冠状动脉慢性完全闭塞病变介入治疗推荐路径.中国介入心脏病学杂志,2018,26(3):121-128.
- [2]Stone GW.Percutaneous coronary intervention of chronic total occlusions:Conquering the final f rontier.JACC Cardiovasc Interv,2018,11(14):1336-1339.
- [3]Marechal P,Davin L,Gach O,et al.Coronary chronic total occlusion intervention:utility or futility.Expert Rev Cardiovasc Ther,2018,16(5):361-367.
- [4]张剑,荆全民,王效增,等.青年慢性完全闭塞冠心病患者临床及介入治疗特点.中国介入心脏病学杂志,2019,27(1):23-27.
- [5]陈帅,龚冬火,沈迎,等.CTO对侧支供血动脉狭窄的生理学评估的影响.中国介入心脏病学杂志,2019,27(1):55-57.
- [6]Werner GS.The role of coronary collaterals in chronic total occlusions.Curr Cardiol Rev,2014,10(1):57-64.
- [7]Toma A,Gebhard C,Gick M,et al.Survival after percutaneous coronary intervention for chronic total occlusion in elderly patients.EuroIntervention,2017,13(2):e228-e235.
- [8]Zimarino M,D'Andreamatteo M,Waksman R,et al.The dynamics of the coronary collateral circulation.Nat Rev Cardiol,2014,11(4):191-197.
- [9]Shen Y,Ding FH,Dai Y,et al.Reduced coronary collateralization in type 2 diabetic patients with chronic total occlusion.Cardiovasc Diabetol,2018,17(1):26.
- [10]Shen Y,Ding FH,Wu F,et al.Association of blood pressure and coronary collateralization in type 2 diabetic and nondiabetic patients with stable angina and chronic total occlusion.JHypertens,2015,33(3):621-626.
- [11]Vamos EP,Harris M,Millett C,et al.Association of systolic and diastolic blood pressure and all-cause mortality in patients newly diagnosed type 2 diabetes:retrospective cohort study.BMJ,2012,345:e5567.
- [12]沈迎,丁风华,张瑞岩,等.经微导管估测冠状动脉侧支血流的临床意义.中国介入心脏病学杂志,2016,24(10):545-551.
- [13]Shen Y,Yang ZK,Hu J,et al.Donor artery stenosis interactions with diastolic blood pressure on coronary collateral flow in type 2 diabetic patients with chronic total occlusion.Cardiovasc Diabetol,2018,17(1):76.
- [14]Hinkel R,Howe A,Renner S,et al.Diabetes mellitus-induced microvascular destabilization in the myocardium.J Am Coll Cardiol,2017,69(2):131-143.
- [15]Cushman WC,Evans GW,Byington RP,et al.Effects of intensive blood-pressure control in type 2 diabetes mellitus.NEngl J Med,2010,362(17):1575-1585.
- [16]Ladwiniec A,Cunnington MS,Rossington J,et al.Collateral donor artery physiology and the influence of a chronic total occlusion on fractional flow reserve.Circ Cardiovasc Interv,2015,8(4)Pii:e002219.
- [17]Mohdnazri SR,Karamasis GV,Al-Janabi F,et al.The impact of coronary chronic total occlusion percutaneous coronary intervention upon donor vessel f ractional f low reserve and instantaneous wave-f ree ratio:implications for physiologyguided PCI in patients with CTO.Catheter Cardiovasc Interv,2018,92(3):E139-E148.
- [18]Tigen K,Durmu?E,Sari I.Recanalization of a total occlusion with marked retrograde collateral supply:impact of collateral circulation on fractional flow reserve measurements of donor artery.J Invasive Cardiol,2014,26(6):E70-E75.
- [19]Toma A,St?hli BE,Gick M,et al.Comparison of benefit of successful percutaneous coronary intervention for chronic total occlusion in patients with versus without reduced(≤40%)left ventricular ejection f raction.Am J Cardiol,2017,120(10):1780-1786.
- [20]Jang WJ,Yang JH,Choi SH,et al.Long-term survival benefit of revascularization compared with medical therapy in patients with coronary chronic total occlusion and well-developed collateral circulation.JACC Cardiovasc Intv,2015,8(2):271-279.
- [21]Werner GS,Martin-Yuste V,Hildick-Smith D,et al.Arandomized multicentre trial to compare revascularization with optimal medical therapy for the treatment of chronic total coronary occlusions.Eur Heart J,2018,39(26):2484-2493.
- [22]Ybarra LF,Cantarelli MJC,Lemke VMG,et al.Percutaneous coronary intervention in chronic total occlusion.Arq Bras Cardiol,2018,110(5):476-483.
- [23]Sousa-Uva M,Neumann FJ,Ahlesson A,et al.2018 ESC/EACTSguidelines on myocardial revascularization.Eur Heart J,2019,55:4-90.
- [24]Tajti P,Burke MN,Karmpaliotis D,et al.Update in the percutaneous management of coronary chronic total occlusions.JACC Cardiovasc Interv,2018,11(7):615-625.
- [25]Ying LH,Fan YS,Lu Y,et al.Intravascular ultrasound guided retrograde guidewire true lumen tracking technique for chronic total occlusion intervention.J Geriatr Cardiol,2018,15(2):199-202.
- [26]Jia H,Hu S,Liu H,et al.Chronic total occlusion is associated with a higher incidence of malapposition and uncovered stent struts:OCT findings at 6 months following DES implantation.Catheter Cardiovasc Interv,2017,89(S1):582-591.
- [27]Song L,Maehara A,Finn MT,et al.Intravascular ultrasound analysis of intraplaque versus subintimal tracking in percutaneous intervention for coronary chronic total occlusions and association with procedural outcomes.JACC Cardiovasc Interv,2017,10(10):1011-1021.
- [28]Karatasakis A,Danek BA,Karmpaliotis D,et al.Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention.Int J Cardiol,2016,224:50-56.
- [29]Tajti P,Karmpaliotis D,Alaswad K,et al.The hybrid approach to chronic total occlusion percutaneous coronary iIntervention:update from the PROGRESS CTO registry.JACC Cardiovasc Interv,2018,11(14):1325-1335.
- [30]Dautov R,Urena M,Nguyen CM,et al.Safety and effectiveness of the surf ing technique to cross septal collateral channels during retrograde chronic total occlusion percutaneous coronary intervention.EuroIntervention,2017,12(15):e1859-e1867.
- [31]Shah A.Chronic total occlusion coronary intervention:in search of a definitive benefit.Methodist DeBakay Cardiovasc J,2018,14(1):50-59.