Chronic Total Occlusion Percutaneous Coronary Intervention: Present and Future.

IF 7.4 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Emmanouil S Brilakis, Yader Sandoval, Lorenzo Azzalini, Gregor Leibundgut, Roberto Garbo, Allison B Hall, Rhian E Davies, Kambis Mashayekhi, Masahisa Yamane, Alexandre Avran, Jaikirshan J Khatri, Khaldoon Alaswad, Farouc A Jaffer, Stephane Rinfret
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引用次数: 0

Abstract

Chronic total occlusion percutaneous coronary intervention has evolved into a subspecialty of interventional cardiology. Using a variety of antegrade and retrograde techniques, experienced operators currently achieve success rates of 85% to 90%, with an incidence of major periprocedural complications of ≈2% to 3%. Several developments in equipment (new microcatheters and guidewires, novel reentry devices), imaging (computed tomography angiography guidance, intravascular imaging for reentry), techniques (intraocclusion contrast injection, advanced subintimal tracking and reentry), and artificial intelligence (automated computed tomography image analysis and prediction of the likelihood of crossing success with various techniques) could further improve outcomes. Global collaboration and rapid dissemination of new developments accelerate the pace of progress. While innovation is exciting and necessary, adhering to the basic principles of chronic total occlusion percutaneous coronary intervention (such as continual assessment of risks and benefits, meticulous angiographic review, and use of dual injection) remains critical for achieving optimal patient outcomes.

慢性全闭塞经皮冠状动脉介入治疗:现在和未来。
慢性全闭塞经皮冠状动脉介入治疗已经发展成为介入心脏病学的一个亚专科。使用各种顺行和逆行技术,经验丰富的操作人员目前的成功率为85%至90%,主要围手术期并发症的发生率约为2%至3%。设备(新型微导管和导丝、新型再入装置)、成像(计算机断层血管造影引导、血管内成像用于再入)、技术(闭塞内造影剂注射、高级内膜下跟踪和再入)和人工智能(自动计算机断层图像分析和预测各种技术交叉成功的可能性)的一些发展可以进一步改善结果。全球合作和新发展的迅速传播加快了进步的步伐。虽然创新是令人兴奋和必要的,但坚持慢性全闭塞经皮冠状动脉介入治疗的基本原则(如持续评估风险和益处,细致的血管造影检查和双重注射的使用)仍然是实现最佳患者结果的关键。
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来源期刊
Circulation: Cardiovascular Interventions
Circulation: Cardiovascular Interventions CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
10.30
自引率
1.80%
发文量
221
审稿时长
6-12 weeks
期刊介绍: Circulation: Cardiovascular Interventions, an American Heart Association journal, focuses on interventional techniques pertaining to coronary artery disease, structural heart disease, and vascular disease, with priority placed on original research and on randomized trials and large registry studies. In addition, pharmacological, diagnostic, and pathophysiological aspects of interventional cardiology are given special attention in this online-only journal.
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