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Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention A Global Expert Consensus Document  期刊论文  

  • 编号：
    f17f70f0-d181-4a3f-82d9-ee343dab9930
  • 作者：
    Brilakis, Emmanouil S.[1,2];Mashayekhi, Kambis[3];Tsuchikane, Etsuo[4];Rafeh, Nidal Abi[5];Alaswad, Khaldoon[6];Araya, Mario[7];Avran, Alexandre[8];Azzalini, Lorenzo[9];Babunashvili, Avtandil M.[10];Bayani, Baktash[11];Bhindi, Ravinay[12,13];Boudou, Nicolas[14];Boukhris, Marouane[15];Bozinovic, Nenad Z.[16];Bryniarski, Leszek[17];Bufe, Alexander[18,19,20];Buller, Christopher E.[21];Burke, Nicholas;Buettner, Heinz Joachim[3];Cardoso, Pedro[22,23];Carlino, Mauro[9];Christiansen, Evald H.[24];Colombo, Antonio[25,26];Croce, Kevin[27];Damas de los Santos, Felix[28];De Martini, Tony[29];Dens, Joseph[30];Di Mario, Carlo[31];Dou, Kefei[32,33,34];Egred, Mohaned[35,36];ElGuindy, Ahmed M.[37,38];Escaned, Javier[39,40];Furkalo, Sergey[41];Gagnor, Andrea[42];Galassi, Alfredo R.[43];Garbo, Roberto[44];Ge, Junbo(葛均波)[45]Goel, Pravin Kumar[46];Goktekin, Omer[47];Grancini, Luca[48];Grantham, J. Aaron[49];Hanratty, Colm[50];Harb, Stefan[51];Harding, Scott A.[52];Henriques, Jose P. S.[53];Hill, Jonathan M.[54];Jaffer, Farouc A.[55];Jang, Yangsoo[56];Jussila, Risto[57];Kalnins, Artis[58];Kalyanasundaram, Arun[59];Kandzari, David E.[60];Kao, HsienLi[61];Karmpaliotis, Dimitri[62];Kassem, Hussien Heshmat[63,64];Knaapen, Paul[65];Kornowski, Ran[66];Krestyaninov, Oleg[67];Kumar, A. V. Ganesh[68];Laanmets, Peep[69];Lamelas, Pablo[70,71];Lee, SeungWhan[72];Lefevre, Thierry[73];Li, Yue[74];Lim, SooTeik[75];Lo, Sidney[76,77];Lombardi, William[78];McEntegart, Margaret[79];Munawar, Muhammad[80];Navarro Lecaro, Jose Andres[81,82];Ngo, Hung M.[83];Nicholson, William[84];Olivecrona, Goran K.[85];Padilla, Lucio[86];Postu, Marin[87];Quadros, Alexandre[88];Hanna Quesada, Franklin[89];Rao, Vithala Surya Prakasa[90];Reifart, Nicolaus[91];Saghatelyan, Meruzhan[92];Santiago, Ricardo;Sianos, George[93];Smith, Elliot[94];Spratt, James C.;Stone, Gregg W.[95];Strange, Julian W.[96];Tammam, Khalid[97];Ungi, Imre[98,99];Vo, Minh[100];Vu Hoang Vu;Walsh, Simon[50];Werner, Gerald S.;Wolimuth, Jason R.[101];Wu, Eugene B.;Wyman, R. Michael[102];Xu, Bo[103];Yamane, Masahisa[104];Ybarra, Luiz F.[105];Yeh, Robert W.[106];Zhang, Qi[107];Rinfret, Stephane[108];
  • 语种：
    英文
  • 期刊：
    CIRCULATION ISSN：0009-7322 2019 年 140 卷 5 期 (420 - 433) ; JUL 30
  • 收录：
     
  • 关键词：
    coronary occlusion methods percutaneous coronary intervention treatment outcome
  • 摘要：

    Outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have improved because of advancements in equipment and techniques. With global collaboration and knowledge sharing, we have identified 7 common principles that are widely accepted as best practices for CTO-PCI. 1. Ischemic symptom improvement is the primary indication for CTO-PCI. 2. Dual coronary angiography and in-depth and structured review of the angiogram (and, if available, coronary computed tomography angiography) are key for planning and safely performing CTO-PCI. 3. Use of a microcatheter is essential for optimal guidewire manipulation and exchanges. 4. Antegrade wiring, antegrade dissection and reentry, and the retrograde approach are all complementary and necessary crossing strategies. Antegrade wiring is the most common initial technique, whereas retrograde and antegrade dissection and reentry are often required for more complex CTOs. 5. If the initially selected crossing strategy fails, efficient change to an alternative crossing technique increases the likelihood of eventual PCI success, shortens procedure time, and lowers radiation and contrast use. 6. Specific CTO-PCI expertise and volume and the availability of specialized equipment will increase the likelihood of crossing success and facilitate prevention and management of complications, such as perforation. 7. Meticulous attention to lesion preparation and stenting technique, often requiring intracoronary imaging, is required to ensure optimum stent expansion and minimize the risk of short- and long-term adverse events. These principles have been widely adopted by experienced CTO-PCI operators and centers currently achieving high success and acceptable complication rates. Outcomes are less optimal at less experienced centers, highlighting the need for broader adoption of the aforementioned 7 guiding principles along with the development of additional simple and safe CTO crossing and revascularization strategies through ongoing research, education, and training.

  • 推荐引用方式
    GB/T 7714：
    Brilakis Emmanouil S.,Mashayekhi Kambis,Tsuchikane Etsuo, et al. Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention A Global Expert Consensus Document [J].CIRCULATION,2019,140(5):420-433.
  • APA：
    Brilakis Emmanouil S.,Mashayekhi Kambis,Tsuchikane Etsuo,Rafeh Nidal Abi,&Rinfret Stephane.(2019).Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention A Global Expert Consensus Document .CIRCULATION,140(5):420-433.
  • MLA：
    Brilakis Emmanouil S., et al. "Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention A Global Expert Consensus Document" .CIRCULATION 140,5(2019):420-433.
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