冠状动脉慢性完全闭塞合并分叉病变介入治疗

慢性完全闭塞病变成为经皮冠脉介入术治疗"最后的堡垒"。成功开通闭塞病变,可改善心绞痛症状、生活质量、左室射血分数和远期预后。慢性闭塞合并分叉病变时,介入治疗操作更复杂。随着各种正向/逆向技术发展和新型器械的应用,闭塞血管开通率逐渐提升,但分支闭塞风险仍较高。分支闭塞导致围手术期心肌梗死和主要心脏不良事件发生率升高。慢性闭塞合并分叉病变介入治疗过程中容易出现冠状动脉夹层和假腔,影响分支血流。使介入手术难度增加、成功率降低和并发症增多。

Percutaneous Coronary Intervention for Chronic Total Occlusion with Bifurcation Lesions

Chronic total occlusion( CTO) of coronary artery becomes the "last bastion"of percutaneous coronary intervention.Successful opening of chronic obstructive diseases can effectively improve angina symptoms,quality of life,left ventricular ejection fraction and long-term prognosis. If chronic occlusion of coronary artery is accompanied with bifurcation lesions,the operation of interventional therapy is quite complex. With the development of various forward/reverse techniques and the application of new equipment,the opening rate of occluded vessels is increased gradually,but the risk of side branch occlusion is still high. Bifurcation occlusion leads to increased perioperative myocardial infarction and major adverse cardiac events. CTO with bifurcation lesions is prone to coronary dissection and pseudolumen during interventional procedure,which affects the branch blood flow,and it increased the difficulty of interventional surgery,reduced the success rate and increased the complications.