TOI支架术在冠脉闭塞病变介入治疗中的应用  

Treatment of total coronary artery occlusion by total occlusion intervention technology

作　　者：于军[1] 薛成相[1] 陈万强[1] 汤洪[1] 李永慧[1] 王菲[1] 杨瑞金[1] 

机构地区：[1]解放军第三医院心内科,陕西宝鸡721004

出　　处：《西北国防医学杂志》2006年第5期350-352,共3页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的：探讨完全闭塞难治病变介入治疗技术（TOI）对冠状动脉完全闭塞病变（CTO）介入治疗的成功率和疗效。方法：经冠状动脉造影选择冠状动脉完全闭塞的陈旧性心肌梗死的患者149例进行回顾性分析，其中男性86例，女性63例，平均年龄（61±14）岁，完全闭塞的病变血管中，前降支（LAD）61例，回旋支（CX）31例，右冠状动脉（RCA）57例，根据心肌梗死发生的时间长短分为小于3个月、3—6个月和大于6个月3组，均采用TOI支架植入技术行冠状动脉支架植入血管血运重建术。结果：149例完全闭塞的血管，支架植入血管完全重建134例，成功率89．9％，其中LAD失败7例，CX失败8例，其中钢丝未通过闭塞病变者8例，球囊未通过闭塞病变者6例，血管未充分扩张，支架无法植入1例，均发生在3—6个月和大于6个月组，所有病例术中及术后未发生严重并发症。结论：在冠状动脉完全闭塞血管行经皮冠状动脉介入治疗（PCI）中，采用TOI介入治疗技术可显著提高完全闭塞冠脉的再通率，且并发症未增加；CTO发生的时间和部位不同也影响冠脉血管的再通率。Objective：To study the clinical value of treatment of total coronary artery occlusion by total occlusion intervention （TOI） technology. Methods： In this study, 149 patients with total coronary artery occlusion disease were included, who were divided into three groups according to the occlusion time： T1 group （ ≤3 months）, T2 group （3 - 6 months）, and T3 group （ 〉= 6 months）. All patients were treated by TOI technology. Results： The total successful rate of operation was 89.9% （134/149）. In 15 patients not receiving successful operation, 7 had occlusion of left anterior descending brand, and 8 had occlusion of the circumflex artery. Cardiac events didn＇ t develop during and after operation. Conclusion： TOI treatment is effective for revascularization of chronic total coronary artery occlusion, and its complication is not significantly increased. The time and location of occlusion may be associated with the successful rate of operation.

关 键 词：冠状动脉 闭塞病变 血管成形术 

分 类 号：R541.4[医药卫生—心血管疾病]