Coronary Artery Chronic Total Occlusion

作     者：Calvin Choi Nayan Agarwal Ki Park R.David Anderson 

作者机构：Division of Cardiovascular MedicineUniversity of Florida1600 SW Archer RoadGainesvilleFL 32610-0277USA 

出 版 物：《Cardiovascular Innovations and Applications》 (心血管创新与应用（英文）)

年 卷 期：2016年第1卷第B5期

页      面：325-335页

学科分类：10[医学] 

主　　题：coronary artery disease chronic total occlusion percutaneous coronary intervention 

摘      要：Coronary artery chronic total occlusion(CTO)is defi ned as an occluded coronary artery segment without anterograde fl ow for at least three *** can be classified as a“trueor“functionalCTO based on flow ***“trueCTO,there is no anterograde ***“functionalCTO,there is minimal anterograde flow through the occluded segment of the coronary *** is a common fi nding during coronary angiography and its prevalence may vary depending on the reported *** patients without previous coronary artery bypass grafting(CABG),CTO is found in about 20–30% of the *** may develop insidiously over a period of time and involve a complex interplay between intracellular and extracellular factors,smooth muscle and foam cells,calcifi cation,and *** is a growing body of evidence to support that CTO revascularization may improve clinical outcome when compared to medical *** the European and American cardiovascular societies support CTO revascularization with a class 2a recommendation(level of evidence B).Historically,due to low procedural success rate,apparent ineffi cient resource utilization,potential increase in complication rates and uncertain clinical benefi ts,only about 10–20%of patients with CTO are treated with percutaneous coronary intervention(PCI).Recent advances using novel and innovative techniques with dedicated equipment have signifi cantly improved the procedural success rate for CTO PCI to about 90%in the hands of experienced *** increasing interest in CTO PCI coupled with increased educational effort,CTO PCI likely will become more accessible to patients in need of CTO *** advancement in innovative techniques and equipment will continue to improve procedural success rates and reduce procedural complication rate for CTO ***,there are a number of prospective clinical trials on the horizon which should help defi ne the clinical benefi ts and limitat