[1]吴晓明,王波,崔晓剑,等.冠状动脉CT血管成像评价冠状动脉慢性完全闭塞病变形态学参数在介入治疗指导中的应用[J].介入放射学杂志,2025,34(02):140-144.
 WU Xiaoming,WANG Bo,CUI Xiaojian,et al.Application of coronary CT angiography evaluation of morphological parameters of coronary chronic total occlusion in guiding interventional therapy[J].journal interventional radiology,2025,34(02):140-144.
点击复制

冠状动脉CT血管成像评价冠状动脉慢性完全闭塞病变形态学参数在介入治疗指导中的应用()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
34
期数:
2025年02
页码:
140-144
栏目:
心脏介入
出版日期:
2025-02-17

文章信息/Info

Title:
Application of coronary CT angiography evaluation of morphological parameters of coronary chronic total occlusion in guiding interventional therapy
作者:
吴晓明王波崔晓剑舒锦尔
Author(s):
WU XiaomingWANG BoCUI XiaojianSHU Jin′er.
Department of Interventional Radiology,Jinhua Municipal People′s Hospital,Jinhua,Zhejiang Province 321000,China
关键词:
【关键词】冠状动脉慢性完全闭塞病变冠状动脉CT血管成像形态学介入治疗
文献标志码:
A
摘要:
【摘要】目的研究冠状动脉CT血管成像(CCTA)评价冠状动脉慢性完全闭塞病变(chronic total occlusion,CTO)形态学参数在介入治疗指导中的应用价值。方法选取2021年1月至2023年12月金华市人民医院收治的经冠状动脉造影(ICA)证实的CTO患者300例,患者术前均接受CCTA检查。记录CCTA形态学参数闭塞段近端形态、闭塞血管长度、闭塞段内线样强化长度、闭塞段内线样强化长度/闭塞血管长度、闭塞段血管线样强化、闭塞段内血管钙化情况、闭塞段内血管钙化面积≥横截面50%、病变走行迂曲(>45°)、侧支血管情况、血管开口病变,并分析以上参数与PCI治疗结果的关系。结果300例CTO患者病变共325处,PCI治疗成功227处(69.85%),PCI治疗失败98处(30.15%);失败组闭塞段近端钝形、闭塞血管长度、闭塞段内血管钙化面积≥横截面50%、病变走行迂曲(>45°)明显高于成功组(P<0.05),闭塞段内线样强化长度、闭塞段内线样强化长度/闭塞血管长度、闭塞段内线样强化明显低于成功组(P<0.05),两组其余参数差异均无统计学意义(P>0.05);多因素logistic回归分析结果显示,闭塞段内线样强化长度(OR=1.975,95%CI:1.306~2.988)、闭塞段内线样强化长度/闭塞血管长度(OR=3.831,95%CI:1.332~11.017)、闭塞段内线样强化(OR=1.702,95%CI:1.007~2.879)是预测PCI治疗成功的相关因素(P<0.05)。结论CCTA评价冠状动脉CTO形态学参数在介入治疗中具有一定的指导作用,其中闭塞段内线样强化长度、闭塞段内线样强化长度/闭塞血管长度、闭塞段内线样强化是预测PCI治疗成功的相关因素。

参考文献/References:

[1]Werner GS,Hildick-Smith D,Martin Yuste V,et al.Three-year outcomes of a randomized multicentre trial comparing revascularization and optimal medical therapy for chronic total coronary occlusions (EuroCTO)[J].Euro Intervention,2023,19:571-579.
[2]Ybarra LF,Rinfret S.Why and how should we treat chronic total occlusion? Evolution of state-of-the-art methods and future directions[J].Can J Cardiol,2022,38:S42-S53.
[3]管浩,崔锦钢,袁建松,等.左心室射血分数减低患者冠状动脉慢性完全闭塞病变介入治疗的安全性及远期疗效[J].中国循环杂志,2021,36:953-960.
[4]Ayoub M,Mashayekhi K,Behnes M,et al.Prognostic value of different levels of uric acid in patients with coronary chronic total occlusion undergoing percutaneous coronary intervention[J].J Clin Med,2023,12:3794-3802.
[5]Opolski MP,Nap A,Knaapen P.A computed tomography algorithm for crossing coronary chronic total occlusions:riding on the wave of the proximal cap and distal vessel segment[J].Neth Heart J,2021,29:42-51.
[6]Xing HR,Zhang LJ,Zhang DF,et al.Quantitative coronary computed tomography angiography assessment of chronic total occlusion percutaneous coronary intervention[J].Quant Imaging Med Surg,2022,12:3625-3639.
[7]孟利民,谷国强.慢性冠状动脉完全闭塞病变介入治疗并发症风险评估进展[J].临床心血管病杂志,2021,37:979-982.
[8]Everaars H,Schumacher SP,Stuijfzand WJ,et al.Functional recovery after percutaneous revascularization of coronary chronic total occlusions:insights from cardiac magnetic resonance tissue tracking[J].Int J Cardiovasc Imaging,2021,37:3057-3068.
[9]王智琪,李佩钊,郑金刚.CTO患者PCI与口服药物治疗疗效比较的荟萃分析[J].中华心血管病杂志,2022,50:591-599.
[10]黄科,胡宪清,郑国庆.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[J].介入放射学杂志,2024,33:52-56.
[11]Cui C,Sheng Z.Outcomes of percutaneous coronary intervention for chronic total occlusions in the elderly:a systematic review and meta-analysis[J].Clin Cardiol,2021,44:27-35.
[12]杜旭,王永,吴天兵,等.冠状动脉慢性完全闭塞性病变逆向介入治疗失败的发生率和预测因素研究[J].中国动脉硬化杂志,2021,29:891-895.
[13]Du G,Cao M,Hou Z,et al.The value of quantitative plaque analysis based on coronary computed tomography angiography in predicting the percutaneous coronary intervention outcome of chronic total occlusion lesions[J].Quant Imaging Med Surg,2023,13:1563-1576.
[14]殷磊,滕彬彬,马明平,等.基于冠状动脉CT血管成像的慢性完全闭塞病变评分在介入治疗中的预测价值[J].中华放射学杂志,2020,54:17-22.
[15]乐颖慧,邢浩然,王锐,等.冠状动脉CT血管造影评估冠状动脉慢性完全性闭塞[J].中国介入影像与治疗学,2023,20:97-101.
[16]杜光舟,侯志辉,郑海生,等.冠状动脉CT血管成像分析慢性完全闭塞病变特征与PCI成功相关性[J].临床放射学杂志,2020,39:1327-1332.

备注/Memo

备注/Memo:
(收稿日期:2024-05-06)
(本文编辑:茹实)
更新日期/Last Update: 2025-02-17