Retrograde Recanalization of Chronic Coronary Occlusions
Journal Title: Advancements in Cardiovascular Research - Year 2018, Vol 1, Issue 3
Abstract
Chronic coronary occlusion (SRT) is recorded in 1 of 5 patients who underwent cardiac catheterization. Interventional interventions in patients with IHD with chronic coronary occlusions are among the most difficult for technical implementation of interventions [1-4]. The main obstacles for the introduction of SRT revascularization programs in the clinic are the issues of clinical feasibility (determining the viability of the myocardium in the zone of the perfused artery), the cost of the expendable material, the time of the operation, the need for additional access, etc. [2]. Analyzing data from the National Cardiovascular Data Registry (NCDR), the US indicates that the recanalization of SRT was only 4% of all procedures (22,365 of 594,510). And the success of SRT interventions was 59%, whereas in the traditional angioplasty/stenting group this indicator reached 96%, accompanied by an (1.6% vs. 0.8%) [2,3].Chronic coronary occlusion (CTO) is fixed at 1 in 5 patients who underwent cardiac catheterization. Recanalization of chronic coronary occlusions is one of the most difficult for the technical performance of interventional procedures. Successful recanalization CTO associated with better survival compared to patients where the procedure of recanalization of occlusion was not successful. Thus, potential candidates for retrograde recanalization of chronic occlusions of coronary arteries may be: patients after a failed attempt of recanalization with clear indications and motivated to implement PCI; refractory angina with CTO of native coronary arteries after CABG; single-vessel coronary artery disease - RCA or the LAD with preserved left ventricular function and preserved kidney; patients with multivessel disease and related comorbidity, which does not allow to perform coronary artery bypass surgery. From 2007 to the present time we have carried out 125 of retrograde recanalization of chronic occlusions of coronary arteries with a total efficiency of 66.4%. Our data suggest that CTO intervention most often used in LAD - 50% of the RCA - 41.7%, and LCx - in 8.3% of cases. It was succesfull method in CTO cases of RCA - in 86.6% of cases, LAD - in 66% of patients and occlusion and in case of Cx CTO recanalization was succesfull in only 2 patients. Septal collaterals with retrograde approach used in most cases- 101 patients, epicardial collaterals - in 19 cases, and in 4 cases of retrograde access served venous bypass and one mammary coronary bypass – to the LAD
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- EP ID EP586916
- DOI 10.32474/ACR.2018.01.000111
- Views 94
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