Factors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention.

IF 0.2 0 PHILOSOPHY
Interventional Cardiology Review Pub Date : 2021-10-12 eCollection Date: 2021-04-01 DOI:10.15420/icr.2021.03
Kalaivani Mahadevan, Claudia Cosgrove, Julian W Strange
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引用次数: 0

Abstract

Stent failure remains one of the greatest challenges for interventional cardiologists. Despite the evolution to superior second- and third-generation drug-eluting stent designs, increasing use of intracoronary imaging and the adoption of more potent antiplatelet regimens, registries continue to demonstrate a prevalence of stent failure or target lesion revascularisation of 15-20%. Predisposition to stent failure is consistent across both chronic total occlusion (CTO) and non-CTO populations and includes patient-, lesion- and procedure-related factors. However, histological and pathophysiological properties specific to CTOs, alongside complex strategies to treat these lesions, may potentially render percutaneous coronary interventions in this cohort more vulnerable to failure. Prevention requires recognition and mitigation of the precipitants of stent failure, optimisation of interventional techniques, including image-guided precision percutaneous coronary intervention, and aggressive modification of a patient's cardiovascular risk factors. Management of stent failure in the CTO population is technically challenging and itself begets recurrence. We aim to provide a comprehensive review of factors influencing stent failure in the CTO population and strategies to attenuate these.

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影响慢性全闭塞冠状动脉介入治疗中支架失效的因素
支架失效仍是介入心脏病专家面临的最大挑战之一。尽管第二代和第三代药物洗脱支架设计日臻完善,冠状动脉内成像技术的应用日益广泛,抗血小板治疗方案的效力也越来越强,但登记研究仍显示支架失败或靶病变血运重建的发生率高达 15-20%。慢性全闭塞(CTO)和非全闭塞人群的支架失效倾向是一致的,包括患者、病变和手术相关因素。然而,CTO特有的组织学和病理生理学特性,以及治疗这些病变的复杂策略,可能会使这部分人群的经皮冠状动脉介入治疗更容易失败。要预防这种情况的发生,就必须识别并减少支架失效的诱因,优化介入技术,包括图像引导下的精确经皮冠状动脉介入治疗,并积极改变患者的心血管风险因素。CTO 患者支架失效的处理在技术上极具挑战性,其本身也会导致复发。我们的目标是全面回顾影响 CTO 患者支架失效的因素以及缓解这些因素的策略。
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
Interventional Cardiology Review
Interventional Cardiology Review Medicine-Cardiology and Cardiovascular Medicine
CiteScore
0.30
自引率
0.00%
发文量
18
审稿时长
12 weeks
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