CTO病变介入治疗技巧ppt课件

arfollowup,essfulOlivari,etal.,May21,2003At12months,essfulCTOprocedureexperienced:LowerincidenceofcardiacdeathsorMI’s(1.05%vs7.23%,p=0.005)ReducedneedforCABG(2.45%vs15.7%,p<0.0001)Freeofangina(88.7%vs75%,p=.0008)*开通CTO的理由-?es“Longtermpatencyafterrecanalizationofold,lusionsinpatientswithanginapectorisisassociatedwithimprovementinglobalandregionalleftventricularfunctions”Sirnes,P.A,etal.,EuropeanHeartJournal19(2)273-81,95patientswithrecanalizedCTOLeftventriculogramatbaselineand6.7monthfollowupLVEFincreasedfrom.062to.067(p=.001)Possiblerecoveryofhibernatingmyocardium*CTO病变介入治疗技巧非CTO病变的介入治疗成功率:>95%CTO病变的介入治疗成功率:大约60%essispassageoftheguidewireacrossthelesion!!!*CTO病变介入治疗技巧常见的失败原因容易成功病变(病例)的选择器械的选择方法的选择何时应该停止手术药物支架的效果并发症的处理*CTO操作常见的失败原因导丝不能通过(85%)包括不能穿透闭塞近端/远端纤维帽,进入假腔,或穿孔球囊不能通过(10%)不能扩张病变(5%)*