RESUMO
OBJECTIVE: To analyze the angiographic results of endovascular treatment for chronic coronary occlusions in patients with coronary heart disease. MATERIAL AND METHODS: In 2009 to 2013 attempted endovascu-ar recanalization of chronic coronary occlusions in 854 patients with coronary heart disease. The patients' age ranged from3 6 to 68 years (mean 52 years). The estimated du-ation of occlusion was m1 onth to more than 3 years. There were 193 (22.6%) females and 661 (77.4%) males. 462 (54.1%) patients had a history of myocardial infarction. 738 (86.4%) and 116 (13.6%) patients had true (TIMI grade 0) and functional (TIMI grade i1 occlusions, respectively. Multi- and univascular lesions were found in 683 (79.9%) and 171 (20.1%) patients, respectively. Silent occlusions with preserved myocardial contractility were identified in 165 (19.3%) patients. RRESULTS:Blood flow could be successfully restored in 616 (72.1%) patients. Recanalization of chronic coronary occlusion failed in 238 (27.9%) patients. CCONCLUSION:Recanalization of chronic coronary occlusions is a highly effective and relatively safe technique. The efficiency of the procedure largely depends on the duration of occlusion, its X-ray morphological characteristics, and the experience of a physician.
Assuntos
Oclusão Coronária , Vasos Coronários , Procedimentos Endovasculares/métodos , Complicações Pós-Operatórias/prevenção & controle , Radiografia Intervencionista/métodos , Angiografia Coronária/métodos , Oclusão Coronária/diagnóstico , Oclusão Coronária/fisiopatologia , Oclusão Coronária/cirurgia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Moscou , Avaliação de Processos e Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/classificação , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
A coronary intravascular ultrasound study (CIUSS) allows accurate estimation of coronary artery lumen and the structure of its wall. In the past 20 years, CIUSS has gained wide acceptance as an additional study. At present, it is mainly used to determine management tactics for coronary artery lesions during percutaneous coronary interventions and their degree in the situations where there are doubts about the need for treatment. CIUSS estimation of the magnitude of stenosis is also useful in the identification of coronary bed lesions that do not induce myocardial ischemia, whose vascularizations may be delayed. This review describes the place of CIUSS in modern interventional cardiology.
