中国冠状动脉慢性闭塞病变介入治疗现状初步调查  

Percutaneous treatment of coronary chronic total occlusions in China:the current status

作　　者：葛雷[1] 马健英[1] 秦晴[1] 陆浩[1] 姚康[1] 黄榕翀[1] 黄浙勇[1] 张峰[1] 刘学波[1] 王灏[1] 钱菊英[1] 葛均波[1] 

机构地区：[1]复旦大学附属中山医院心内科,上海市心血管病研究所,上海200032

出　　处：《上海医学》2009年第12期1049-1052,共4页Shanghai Medical Journal

摘　　要：目的初步调查我国冠状动脉慢性闭塞病变(CTO)介入治疗的现状。方法在2008中国冠状动脉CTO介入治疗俱乐部(CTOCC)活动进行的同时,对全国45位介入治疗专家进行问卷调查。结果本次共发出调查问卷45份,收回43份(95.6%)。CTO介入治疗时术者通常使用硬导引钢丝(48.8%)或亲水多聚物涂层导引钢丝(44.2%),仅7.0%的术者使用软导引钢丝尝试开通闭塞病变。在硬导引钢丝系列中术者最常使用Miracle系列导引钢丝(34.5%),在亲水涂层多聚物涂层导引钢丝中术者最常使用Pilot系列导引钢丝(33.3%)。当第1根导引钢丝无法通过闭塞病变后,术者最常使用的技术为平行导引钢丝技术(71.4%),此时最常使用的导引钢丝为Miracle(46.0%)和Conquest系列导引钢丝(28.6%)。CTO介入治疗中血管内超声(IVUS)的使用率较低,93.1%的术者在CTO介入治疗中IVUS的使用率<5%。患者术前行冠状动脉CT检查的比例较低,67.4%的术者其冠状动脉CT检查的使用率<5%。在逆行导引钢丝技术的应用中,仅1个介入中心(2.2%)的手术量>20例。绝大部分术者(83.7%)的手术成功率<80%。结论与国外CTO介入治疗水平较高的中心相比,国内术者的CTO介入治疗技术仍待进一步提高。为准确了解当前国内CTO的治疗现状,大规模的回顾性分析非常必要。Objective To preliminarily evaluate the current status of percutaneous treatment of coronary chronic total occlusions （CTO） in China. Methods Forty-five cardiac interventionalists were surveyed by questionnaire when they were attending the activity organized by the Chronic Total Occlusions Club, China （CTOCC）, The questionnaire consisted of 10 questions with multiple choice. Results Forty-three （95.6%） valid questionnaires were collected. Stiff wires （48.8%） and polymer-coated hydrophilic wires （44.2%） were commonly used during CTO, and the soft wires were used as the first attempt wire only in 3. 6% of patients. Miracle （34.5%） and Pilot （33.3%） series of guide wires were the most frequently used ones. Parallel wire technique was mainly used when the first guide wire failed to cross the lesions, and under such condition Miracle （46%） and Conquest （28.6%） series of guide wires were usually chosen. The intravascular ultrasound （IVUS）- guided wire was seldom chosen. The application rate of IVUS was less than 5% in 93.1% of the operators. Multi slice computed tomography prior to operation was infrequently performed. The application rate of CT was less than 5 % in 67.4 % of the operators. The number of patients who received retrograde guide wire technique surpassed 20 only in one （2. 2%） interventional center. The success rate was less than 80% in 83. 7% of the operators. Conclusion Compared with their overseas counterparts, interventionalists in China need to further improve their technique. To fully understand the situation of CTO in China, large scale retrospective studies are warranted.

关 键 词：慢性完全闭塞病变 经皮介入治疗 调查问卷 

分 类 号：R543.3[医药卫生—心血管疾病]