| 张俊霞 葛震 王志梅 许田 叶飞 田乃亮 张俊杰 陈绍良△.高龄冠状动脉CTO患者PCI治疗的可行性及安全性[J].,2014,14(36):7151-7153 |
| 高龄冠状动脉CTO患者PCI治疗的可行性及安全性 |
| Feasibility and Safety of PCI of CTO Lesions in Elderly Patients |
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| DOI： |
| 中文关键词: 经皮冠状动脉介入治疗 慢性闭塞性病变 高龄患者 |
| 英文关键词: Percutaneous coronary intervention Chronic total occlusion lesion Elderly patients |
| 基金项目:国家自然科学基金项目（81270191）；江苏省临床医学科技专项（BL2013001) |
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| 中文摘要: |
| 目的：探讨高龄冠状动脉慢性闭塞性病变(CTO)患者经皮冠状动脉介入治疗(PCI)的可行性和安全性。方法：连续入选2007
年07 月至2012 年07 月南京市第一医院年龄≥ 80 岁，因冠状动脉CTO病变行PCI 治疗的患者，回顾性分析和比较患者的基线
特征、病变特征、手术经过和手术相关并发症。结果：共有69例高龄CTO 患者，平均年龄为82.17± 2.70 岁，男性57 例(82.6%)。14
例患者同时存在2 支CTO病变血管，21例患者闭塞近端钙化，24例患者闭塞近端迂曲，5 例患者为原支架内闭塞。30 例经桡动
脉途径行PCI治疗。51 例患者手术成功，手术成功率为73.91%。有7 例患者发生冠脉穿孔，其中1 例出现心脏压塞并院内死亡。
结论：即使通过适当选择患者，80岁以上高龄患者PCI治疗冠状动脉CTO病变的手术成功率可以接受，但手术风险较高，需在有
经验的心导管中心谨慎开展。 |
| 英文摘要: |
| Objective:To investigate the feasibility and safety of the percutaneous coronary intervention (PCI) of chronic total
occlusion lesion (CTO) in elderly patients.Methods:From July 2007 to July 2012, elderly patients (≥ 80 years old) required PCI because
of CTO in Nanjing First Hospital were enrolled in this study. The baseline characteristics, angiographic results, interventional procedures
as well as procedural complications were retrospectively analyzed.Results:Totally, 69 elderly patients with CTO lesions were enrolled
with mean age of 82.17± 2.70 years. Among them, 57 patients (82.6%) were males. 14 patients had two concurrent CTO vessels. Severe
calcification in 21 patients and vessel tortuosity in 24 patients were found proximal to occlusion. In-stent occlusion was found in 5
patients. Cardiac catheterization was accessed in 30 patients through the transradial arteries. Procedural success was achieved in 51 cases
(73.91%). Coronary perforation occurred in 7 cases and 1 case died of cardiac tamponade in hospital.Conclusion:Although procedural
success rate of PCI in elderly CTO patients was acceptable after patient selection, the risk remains high and cautions should be taken to
this elderly cohort even in experienced catheterization centers. |
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