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目的探讨冠状动脉慢性完全闭死病变(CTO)的临床特点。方法对825例冠状动脉造影患者中的57例CTO病变患者行经皮冠状动脉介入治疗(PCI),并对其临床资料进行统计分析。结果57例患者中,单支病变11例,双支病变29例,三支病变17例。在70支病变血管中,无前向血流通过44支,少量血流通过26支;前降支病变32支,回旋支病变16支,右冠状动脉病变22支;闭死时间≤3个月41支,>3个月29支;闭死长度≤20 mm43支,>20 mm27支;闭死末端形态呈鼠尾状42支,呈刀切状28支;70支完全闭死血管成功植入支架57支,PCI成功率81.4%。结论对心肌梗死患者尤其是合并糖尿病的男性患者,早期进行冠状动脉造影,选择适当的病例及病变,对预防CTO形成及提高PCI成功率具有积极的作用。
Objective To investigate the clinical features of chronic total coronary artery occlusion (CTO). Methods Percutaneous coronary intervention (PCI) was performed on 57 CTO patients in 825 coronary angiography patients and their clinical data were analyzed statistically. Results Of the 57 patients, 11 had single-vessel disease, 29 had double-vessel disease, and 17 had three-vessel disease. In 70 vessels, there was no anterior flow through 44, a small amount of blood flow through 26; anterior descending branch of the disease 32, 16 cases of mesenchymal lesions, right coronary artery lesions 22; closed time ≤ 3 months 41 branches, 29 months> 3 months; closed length ≤20 mm43 branches,> 20 mm27; closed tail morphology was tail-like 42, was knife-like 28; 70 fully closed vessel successfully implanted 57 brackets, PCI success rate of 81.4%. Conclusions Coronary angiography in the early stage of myocardial infarction, especially in male patients with diabetes mellitus. Choosing appropriate cases and pathological changes has a positive effect on preventing the formation of CTO and improving the success rate of PCI.