65例冠状动脉慢性闭塞病变介入治疗临床分析

摘要

目的：分析冠状动脉慢性完全闭塞（CTO）病变患者经皮冠状动脉介入治疗（PCI）疗效的影响因素。方法：回顾分析我院2010年1月至2012年12月期间65例患者72处 CTO病变介入治疗的临床资料、病变特征和PCI的疗效。结果：CTO病变 PCI成功率为91.67%（66/72）；CTO病变闭塞时间＞12个月者 PCI成功率显著低于3～12个月者（81.48%比97.78%），闭塞长度＞15mm的 CTO病变 PCI成功率显著低于闭塞长度≤15mm者（78.26%比97.96%）；断端呈刀切状的 CTO病变 PCI 成功率显著低于鼠尾状者（71.43%比96.55%），P 均＜0.05；PCI失败有6处，其中4处因导丝未能通过病变，2处因球囊未能通过病变；介入术中并发症发生率为7.69%，住院期间均无主要不良心血管事件；术后心绞痛症状缓解率为90.16%。结论：冠状动脉慢性完全闭塞病变经皮冠状动脉介入治疗成功率与病变特征、CTO病变闭塞时间等因素有关。%Objective:To analyze influencing factors of percutaneous coronary intervention (PCI) on therapeutic effect in patients With coronary chronic total occlusions (CTO).Methods::Clinical data,lesion features and PCI therapeutic results of 65 patients With 72 CTO lesions,Who received PCI in our hospital from Jan 2010 to Dec 2012, Were retrospectively analyzed.Results:PCI success rate of CTO lesion Was 91.67% (66/72);compared With pa-tients With CTO occlusion 3~12 months,there Was significant decrease in PCI success rate (97.78% vs.81.48%)in those With CTO occlusion>1 2 months;compared With patients With occlusion length≤1 5 mm,there Was significant decrease in PCI success rate (97.96% vs.78.26%)in those With occlusion length >15mm;compared With patients With mouse tail-like broken ends,there Was significant decrease in PCI success rate (96.55% vs.71.43%)in those With knife cut-like broken ends,P<0.05 all;PCI failed in six lesions,in Which four because guideWire failed to pass through lesions and tWo because balloon failed to pass through lesions;incidence rate of complications Was 7.6 9%during PCI,there Were no major adverse cardiovascular events during admission in all patients;symptoms relieving rate of angina pectoris Was 90.16% after PCI.Conclusion:Success rate of percutaneous coronary intervention is re-lated to lesion features,CTO occlusion duration etc.