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血流储备分数

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冠状动脉慢性完全性闭塞病变PCI & 冠脉穿孔

CBSMD

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2017年10月“Incidence, Treatment, and Outcomes of Coronary Perforation During Chronic Total Occlusion Percutaneous Coronary Intervention”提供的横跨6年的CTO-PCI多中心数据呈现了CTO患者群的整体特征。其中冠脉穿孔更常见于高龄和CABG既往史患者群(61% vs 35%, p < 0.001)。经冠脉造影明确的穿孔病变复杂程度更甚(Multicenter CTO Registry in Japan score 3.0 ± 1.2 vs 2.5 ± 1.3, p < 0.001)。 介绍了与冠脉穿孔相关的包括患者年龄、PCI既往史、右冠靶向CTO及若干可导致夹层的CTO介入技术等影响因子。


2019年3月大型多中心CTO-PCI注册研究数据“In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Interventions in Patients With Prior Coronary Artery Bypass Graft Surgery”分析结果显示有CABG既往史的CTO-PCI技术成功率更低(84% versus 89%; P<0.001)，手术成功率更低 (82% versus 87%, P<0.001)。院内主要并发症风险如院内死亡和冠脉穿孔风险更高，分别为(1% versus 0.4%; P=0.016)(7.1% versus 3.1%; P<0.001)。


2018年10月“Procedural Success and Outcomes With Increasing Use of Enabling Strategies for Chronic Total Occlusion Intervention”

介绍了可有效提高CTO病变经皮冠脉介入成功率的策略（Enabling strategy，ES ）在英格兰和威尔士地区大样本数据中的表现及随其数量的增加对冠脉穿孔发生率的负面影响，冠脉穿孔发生率从无ES应用时1.2%攀升至≥3种ES时的4.0% (P<0.001)。


2018年10月“Chronic Total Occlusion Interventions: Update on Current Tips and Tricks”在提供了可提高CTO介入成功技术的同时，系统地介绍了合理预防和治疗PCI相关并发症的方法。

Similarly, an algorithmic approach can help prevent and optimally treat CTO PCI-related complication, such as perforation, radiation, and contrast-induced nephropathy.


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