Optimal Approach in Staged Chronic Total Occlusion Percutaneous Coronary Intervention.

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reports Pub Date : 2025-10-23 DOI:10.1007/s11886-025-02318-4

Sandeep Jalli, Dimitrios Strepkos, Michaella Alexandrou, Deniz Mutlu, Pedro E P Carvalho, Eleni Kladou, Ozgur S Ser, Jaskanwal Deep Singh Sara, Olga Mastrodemos, Bavana V Rangan, Konstantinos Voudris, M Nicholas Burke, Yader Sandoval, Emmanouil S Brilakis

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引用次数: 0

Abstract

Purpose of review: To discuss the optimal timing of staged chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients presenting with acute coronary syndromes (ACS), multiple CTOs and after a CTO modification procedure.

Recent findings: In patients with acute coronary syndromes CTO PCI should be performed as part of a complete revascularization strategy within a few weeks or months from the initial presentation. In patients who undergo CTO modification procedures, such as subintimal tracking and re-entry (STAR) earlier re-intervention (within 1-2 months) is better than later re-intervention. Staged intervention is preferred in most patients who need PCI of more than one CTO to minimize the risk of complications. The optimal timing of CTO intervention as part of a complete revascularization strategy remains unknown, as does the optimal timing of repeat intervention after a CTO modification procedure, though earlier is likely better than later in both cases. PCI of more than one CTO in the same patient should also be staged for safety reasons.

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分阶段慢性全闭塞经皮冠状动脉介入治疗的最佳方法。

目的：探讨急性冠脉综合征（ACS）患者、多发冠脉综合征患者及冠脉综合征改良手术后进行分阶段慢性全闭塞（CTO）经皮冠状动脉介入治疗（PCI）的最佳时机。近期研究发现：急性冠状动脉综合征患者应在发病后几周或几个月内进行CTO PCI，作为完整血运重建术的一部分。在接受CTO改良手术（如内膜下追踪和再入（STAR））的患者中，早期再干预（1-2个月内）优于后期再干预。对于大多数需要一个以上CTO的患者，分期干预是首选，以尽量减少并发症的风险。作为完全血运重建策略的一部分，CTO干预的最佳时机尚不清楚，CTO改良手术后重复干预的最佳时机也不清楚，尽管在这两种情况下，越早越好。出于安全考虑，对同一患者进行一个以上CTO的PCI治疗也应分级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.20

自引率

2.70%

发文量

209

期刊介绍： The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.