无创影像学在冠状动脉慢性完全闭塞病变血运重建中的应用  

Application of Noninvasive Imaging in Revascularization of Chronic Total Occlusion of Coronary Artery

作　　者：罗倩 黄晶 乔瑾 黄明刚[2] LUO Qian;HUANG Jing;QIAO Jin;HUANG Minggang(Xi’an Medical University,Xi’an 710068,Shaanxi,China;Department of CT,Shaanxi Provincial People’s Hospital,Xi’an 710068,Shaanxi,China)

机构地区：[1]西安医学院,陕西西安710068 [2]陕西省人民医院CT室,陕西西安710068

出　　处：《心血管病学进展》2023年第4期308-311,共4页Advances in Cardiovascular Diseases

摘　　要：冠状动脉慢性完全闭塞(CTO)病变占冠状动脉造影确诊为冠心病的20%~30%。尽管经皮冠状动脉介入治疗(PCI)技术发展迅速,但CTO-PCI仍然是冠心病治疗领域最后的壁垒,CTO-PCI失败最常见的原因是导丝或球囊无法通过闭塞病变及球囊不能充分扩张,而冠状动脉夹层、穿孔及同侧侧支损伤则是常见的操作并发症。因此,PCI前需要综合考虑病变的解剖特征、存活心肌及患者的一般情况,选择适合CTO-PCI的患者,现就无创影像学在CTO-PCI中的应用进行简要综述。Chronic total occlusion(CTO)of coronary artery accounts for 20%~30%of coronary heart disease diagnosed by coronary angiography.Despite the rapid development of percutaneous coronary intervention(PCI)technology,CTO-PCI is still the last barrier in the field of coronary heart disease treatment.The most common reason for CTO-PCI failure is that the guide wire or balloon cannot pass through the occlusive lesion and the balloon cannot fully expand.Coronary artery dissection,perforation and injury of ipsilateral collateral are common operational complications.Therefore,before PCI,it is necessary to comprehensively consider the anatomical characteristics of lesions,viable myocardium and the general situation of patients,and select patients suitable for CTO-PCI.Therefore,this article briefly reviews the application of non-invasive imaging in CTO-PCI.

关 键 词：冠心病 慢性完全闭塞 无创影像学 心肌活性 经皮冠状动脉介入治疗 冠状动脉CT血管成像 管腔内衰减梯度 

分 类 号：R541.4[医药卫生—心血管疾病]