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损伤复杂性和与骨关节慢性全闭相关的程序结果:来自PROGRESS-CTO注册表的见解

Salman S Allana¹, Spyridon Kostantinis¹, Bahadir Simsek¹

¹Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.

The Journal of invasive cardiology

|December 18, 2023

概括

针对骨关节慢性全闭 (CTOs) 的皮肤冠状动脉干预 (PCI) 是复杂的,其成功率较低,死亡和中风风险更高. 与非敌对的CTO相比,这个程序需要更复杂的技术和更长的时间.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
血管医学血管医学

背景情况:

骨性慢性全闭症 (CTOs) 在重血管化方面存在独特的挑战.
穿皮冠状动脉干预 (PCI) 是CTO的关键治疗方式.
了解特定于骨性CTO PCI的结果对于改善患者护理至关重要.

研究的目的:

评价通过皮肤冠状动脉干预 (PCI) 对骨慢性全闭塞 (CTOs) 的临床和程序结果.
为了比较敌对CTO PCI与非敌对CTO PCI的成功率和并发症概况.

主要方法:

在2012年至2022年间在35个国际中心进行的8788个CTO PCI程序的回顾性分析.
包括住院的主要不良心脏事件 (MACE),包括死亡,心肌梗塞,紧急重复血管化,吸管和中风.
对比过程成功率,损伤复杂度 (J-CTO分数) 和技术利用率 (逆行方法) 在骨和非骨CTO之间.

主要成果:

骨头CTO占所有CTO的12%,与较高的J-CTO分数有关.
与非敌对的CTO相比,Ostial CTO PCI的技术 (82%对86%) 和程序 (81%对85%) 的成功率较低.
在骨性CTOPCI中,观察到更高的住院死亡率 (0.9%对0.3%) 和中风 (0.5%对0.1%),以及更多地使用逆行技术,更长的手术时间和更高的辐射剂量.

结论:

通常的CTO的特点是更大的复杂性,导致PCI的技术和程序成功减少.
骨CTO的PCI需要更高的逆向方法频率,并且与死亡率和中风风险的增加有关.
这些发现强调了需要专门的技术和仔细的风险评估来管理海上CTO.

关键词:

慢性完全封闭症慢性完全封闭症骨损伤骨损伤骨损伤骨损伤通过皮肤进行冠状动脉干预.

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