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《Chinese Journal of Clinical Medicine》 2018-04
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Clinical efficacy of percutaneous coronary intervention for patients with coronary chronic total occlusion

WU Liang-an;YAO Kang;Department of Cardiology,Xiaoshan Hospital;Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai Institute of Cardiovascular Diseases;  
Objective:To investigate the characteristics and influencing factors of percutaneous coronary intervention(PCI)in Chinese patients with coronary chronic total occlusion(CTO).Methods:Forty patients from the Chronic Total Occlusions Club,China(CTOCC)in 2017 were enrolled,the characteristics of interventional treatment process and the success rate of operation were analyzed.Results:Mean occlusion duration of the 40 patients was 3-56 months,and the mean J-CTO score≥3.All patients underwent coronary CT examination before PCI.Bilateral angiography was used in all cases.Overall success recanalization rate was 92.5%(37/40).Twenty-three patients were successfully recanalized through antgrade approach(23/40,57.5%).Retrograde approach as the primary strategy was applied in 14/40(35%)patients.The most commonly used soft guidewire Sion was used in 82.5%(35/40)of patients,the usage of Runthrough(22/40,55%)ranked next,and the third was Fielder(15/40,37.5%).Stiff wires were commonly used during the operation(32/40,80%),among which Gaia(57.5%),Conquest(47.5%),and Pilot(45%)series of guide wires were used most frequently.The parallel wire technique was mostly applied when the first guide wire failed to cross the lesion.Micro-catheter was used in all cases and Cosair catheter was used most frequently.The intravascular ultrasound(IVUS)was used in 55% of the cases.There were no in-hospital major adverse cardiac events during the follow-up.Conclusions:The success rate of CTOCC cases in 2017 is higher than that of the average success rate of CTO cases reported at home and abroad.This might be due to the experienced operators,full preoperative film reading,high utilization rate of coronary CT,full use of IVUS during operation,reasonable use of guide wires,instruments,and reasonable strategic choices.
【Fund】: 国家重点研发计划项目(No.2016YFC1301200)~~
【CateGory Index】: R541.4
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