冠状动脉慢性闭塞同台和择期介入治疗对手术成功率的影响
The effect of simultaneous coronary angiography and percutaneous coronary intervention versus selective percutaneous coronary intervention on the surgical success rate in treating coronary chronic total occlusion
黄科 1胡宪清 2郑国庆3
作者信息
- 1. 310053 浙江杭州浙江中医药大学第一临床医学院;金华市城投集团医疗康养有限公司筹建组
- 2. 金华市中心医院心血管内科
- 3. 310053 浙江杭州浙江中医药大学第一临床医学院
- 折叠
摘要
目的 探讨同台和择期经皮冠状动脉介入治疗(PCI)对冠状动脉慢性完全闭塞(CTO)病变患者手术成功率的影响.方法 回顾性分析 2020 年 1 月 1 日至 2022 年 12 月 31 日在金华市中心医院接受PCI治疗的 147 例冠状动脉CTO患者临床资料.根据造影后是否即刻行PCI治疗将患者分为同台PCI组(n=64)和择期PCI组(n=83),比较两组间患者临床资料和手术成功率.多因素logisti回归分析判断CTO PCI手术成功的影响因素.结果 同台PCI组病变闭塞长度显著短于择期PCI组(35 mm比 50 mm,P=0.022),其他冠状动脉造影特征比较差异无统计学意义(均P＞0.05).同台PCI组手术成功率显著低于择期PCI组(78.1%比 88.0%,P=0.034).多因素logistic回归分析结果显示,同台PCI(OR=4.617,95%CI=1.900～11.221,P=0.001)、无残端病变(OR=4.381,95%CI=1.821～10.452,P=0.001)、闭塞长度≥20 mm(OR=2.462,95%CI=1.030～5.887,P=0.043)、手术并发症(OR=8.688,95%CI=1.573～47.971,P=0.013)是CTO PCI手术成功的独立影响因素.结论 同台PCI治疗CTO增加手术失败风险.
Abstract
Objective To discuss the effect of simultaneous coronary angiography plus percutaneous coronary intervention(PCI)and selective PCI on the surgical success rate in treating coronary chronic total occlusion(CTO).Methods The clinical data of a total of 147 consecutive patients with coronary CTO,who received PCI treatment at the Jinhua Municipal Central Hospital of China between January 1,2020 and December 31,2022,were retrospectively analyzed.According to whether the patient received PCI immediately after coronary angiography or not,the patients were divided into simultaneous PCI group(n=64)and selective PCI group(n=83).The clinical data and surgical success rate were compared between the two groups.Multivariate logistic regression analysis was used to determine the factors affecting the success of the PCI surgery for coronary CTO.Results The lesion's length of coronary CTO in the simultaneous PCI group was 35 mm,which was obviously shorter than 50 mm in the selective PCI group(P=0.022).No statistically significant differences in the other angiographic findings existed between the two groups(all P＞0.05).The surgical success rate in the simultaneous PCI group was 78.1%,which was remarkably lower than 88.0%in the selective PCI group(P=0.034).Multivariate logistic regression analysis revealed that simultaneous PCI(OR=4.617,95%CI=1.900-11.221,P=0.001),no stump lesion(OR=4.381,95%CI=1.821-10.452,P=0.001),occlusion length≥20 mm(OR=2.462,95%CI=1.030-5.887,P=0.043),and surgical complications(OR=8.688,95%CI=1.573-47.971,P=0.013)were the independent factors influencing the success of PCI surgery for coronary CTO.Conclusion For the treatment of coronary CTO,the simultaneous coronary angiography and PCI treatment may increase the risk of surgical failure.(J Intervent Radiol,2024,32:52-56)
关键词
慢性完全闭塞病变/经皮冠状动脉介入治疗/手术成功率Key words
chronic total occlusion/percutaneous coronary intervention/surgical success rate引用本文复制引用
出版年
2024
NETL
NSTL
万方数据