JACC:慢性完全闭塞血管成形术后的早期手术和健康状况结局

2017-08-21 xiangting MedSci原创

调查CTO PCI的成功率、风险和收益将有助于更准确地将这些手术的知情同意过程文字化,以便有CTO PCI适应证的患者可以更有效地参与这种或其他治疗选择的决策。

鉴于CTO病变血运重建技术的不断发展,迫切需要更准确地对这些复杂手术的成功率、风险和获益进行量化。这项研究旨在准确地描述现代慢性完全闭塞(CTO)经皮冠脉介入术(PCI)治疗的成功率、风险和患者报告的获益。

采用独特的综合性,核心实验室评估,单组多中心登记,通过混合方法入组1000例CTO PCI患者,评估了技术成功率、并发症发生率、以及治疗成功和未成功患者1个月的原始和调整后的健康状况获益。

技术成功率高(86%)。住院和1个月死亡率分别为0.9%和1.3%,48例(4.8%)出现需要治疗的穿孔。幸存者并完成1个月随访(n = 947),平均±SEM西雅图心绞痛问卷的生活质量评分从49.4±0.9提高到75.0±0.7(p <0.01),平均Rose呼吸困难量表评分改善从2.0±0.1至1.1±0.1(p <0.01),1个月时身体健康问卷(抑郁症)评分从6.2±0.2改善至3.5±0.1(p <0.01)。调整基线差异后,成功与不成功CTO PCI之间的西雅图心绞痛调查问卷生活质量的平均组间差异为10.8(95%置信区间:6.3-15.3; p <0.001)。

调查CTO PCI的成功率、风险和收益将有助于更准确地将这些手术的知情同意过程文字化,以便有CTO PCI适应证的患者可以更有效地参与这种或其他治疗选择的决策。

原始出处:

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content=非常好的文章.学习了.很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Aug 22 17:51:16 CST 2017, time=2017-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235709, encodeId=0232235e09ef, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Mon Aug 21 15:26:59 CST 2017, time=2017-08-21, status=1, ipAttribution=), 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    2017-12-31 hbwxf
  5. 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GetPortalCommentsPageByObjectIdResponse(id=235689, encodeId=50a7235689d1, content=学习了,谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Aug 21 12:52:13 CST 2017, time=2017-08-21, status=1, ipAttribution=)]
    2017-08-24 天涯183

    非常好的文章.学习了

    0

  6. 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  7. 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GetPortalCommentsPageByObjectIdResponse(id=235689, encodeId=50a7235689d1, content=学习了,谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Aug 21 12:52:13 CST 2017, time=2017-08-21, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1990131, encodeId=e201199013185, content=<a href='/topic/show?id=66308965e00' target=_blank style='color:#2F92EE;'>#血管成形术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89657, encryptionId=66308965e00, topicName=血管成形术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f5b299, createdName=xuyu, createdTime=Thu Jul 19 19:46:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700489, encodeId=a99c1e004893e, content=<a href='/topic/show?id=9f6c535115f' target=_blank style='color:#2F92EE;'>#慢性完全闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53511, encryptionId=9f6c535115f, topicName=慢性完全闭塞)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Dec 31 04:46:00 CST 2017, time=2017-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236706, encodeId=b82c236e06e3, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Thu Aug 24 15:35:05 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325484, encodeId=54d1132548492, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, 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content=非常好的文章.学习了.很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Aug 22 17:51:16 CST 2017, time=2017-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235709, encodeId=0232235e09ef, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Mon Aug 21 15:26:59 CST 2017, time=2017-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235689, encodeId=50a7235689d1, content=学习了,谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Aug 21 12:52:13 CST 2017, time=2017-08-21, status=1, ipAttribution=)]
    2017-08-22 天涯183

    非常好的文章.学习了.很受益

    0

  9. 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topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Dec 31 04:46:00 CST 2017, time=2017-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236706, encodeId=b82c236e06e3, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Thu Aug 24 15:35:05 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325484, encodeId=54d1132548492, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Wed Aug 23 01:46:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511004, encodeId=753b15110040c, content=<a href='/topic/show?id=5a822e867b5' target=_blank style='color:#2F92EE;'>#健康状况#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27867, encryptionId=5a822e867b5, topicName=健康状况)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9e3710287449, createdName=kkunny, createdTime=Wed Aug 23 01:46:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236080, encodeId=c9e5236080d4, content=非常好的文章.学习了.很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Aug 22 17:51:16 CST 2017, time=2017-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235709, encodeId=0232235e09ef, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Mon Aug 21 15:26:59 CST 2017, time=2017-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235689, encodeId=50a7235689d1, content=学习了,谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Aug 21 12:52:13 CST 2017, time=2017-08-21, status=1, ipAttribution=)]
    2017-08-21 楠博One

    学习谢谢分享

    0

  10. 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createdBy=c22430117406, createdName=redcrab, createdTime=Mon Nov 13 12:46:00 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2004674, encodeId=686220046e4d7, content=<a href='/topic/show?id=4e8a5400816' target=_blank style='color:#2F92EE;'>#成形术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54008, encryptionId=4e8a5400816, topicName=成形术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fb6449, createdName=ZGMFX24A, createdTime=Wed Oct 25 05:46:00 CST 2017, time=2017-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1853736, encodeId=a8661853e36ce, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Dec 31 04:46:00 CST 2017, time=2017-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236706, encodeId=b82c236e06e3, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Thu Aug 24 15:35:05 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325484, encodeId=54d1132548492, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Wed Aug 23 01:46:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511004, encodeId=753b15110040c, content=<a href='/topic/show?id=5a822e867b5' target=_blank style='color:#2F92EE;'>#健康状况#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27867, encryptionId=5a822e867b5, topicName=健康状况)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9e3710287449, createdName=kkunny, createdTime=Wed Aug 23 01:46:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236080, encodeId=c9e5236080d4, content=非常好的文章.学习了.很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Aug 22 17:51:16 CST 2017, time=2017-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235709, encodeId=0232235e09ef, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Mon Aug 21 15:26:59 CST 2017, time=2017-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235689, encodeId=50a7235689d1, content=学习了,谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Aug 21 12:52:13 CST 2017, time=2017-08-21, status=1, ipAttribution=)]
    2017-08-21 惠映实验室

    学习了,谢谢。

    0

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目前来说,相比于传统的球囊血管成形术(BA),紫杉醇洗脱的球囊(PEB)血管成形术在治疗浅表股动脉病变(SFA)上具有明显的优势,但是对于PEB和BA治疗血管内支架置入术后再狭窄的效果如何尚未阐明。近日,在国际心血管权威杂志JAHA上发表了一篇旨在评估比较PEB和BA治疗支架置入术后再狭窄效果的随机临床研究。本研究将有症状的支架置入术后再狭窄的患者随机分成PEB治疗组和BA治疗组,主要终点事件是6

陆信武:长段CTO内膜下血管成形术的技术策略

内膜下血管成形术(Subintimal angioplasty SIA)是治疗下肢动脉长段慢性完全闭塞(Chronic total occlusion CTO)的常用治疗策略,Bolia等于1989年首先对其进行报道,现就内膜下血管成形术的常用技术介绍如下。 1 选择导丝、导管进入内膜下合适的部位和方法 闭塞动脉的近段残留管腔(残腔)对能否施行内膜下血管成形术有时非常重要。

JACC:血液稀释剂可降低血管成形术的死亡率

根据今天在JACC发表的一项研究:接受接受血管成形术的急性冠脉综合征患者可减少各种原因入医院死亡的风险,但当手术结束后给予糖蛋白2B/3A抑制剂(GPI)时,会增加出血的风险。研究人员使用来自国家心血管数据注册CathPCI注册表数据,评估了在2009年7月和2011年9月间970865例急性冠脉综合征患者的记录。尽管在支架的设计和新的抗凝血剂方面有许多进展,如比伐卢定,研究发现,研究中将近三分之

J Endovasc Ther:血管成形术治疗CLI后的重复干预会增加截肢风险

近期有研究表明,对于膝下血管成形术治疗严重肢体缺血(CLI)后的重复干预的需要,可能增加未来重大截肢风险。 来自日本的研究人员对1065名患者的1298个肢体进行了研究分析,患者的平均年龄为72岁,739为男性。在平均随访1.2年(四分位距为0.4-2.5),11%的肢体进行了重大截肢。38%的需要重复干预,其中72例需要旁路手术和427例需要重复血管成形术。Kaplan-Meier第2年重复干预

J Am Heart Assoc:急诊血管成形术后AKI 造影剂是罪魁祸首?

与接受择期干预的患者相比,接受急诊经皮冠状动脉介入治疗(pPCI)的患者被认为具有造影剂(CM)诱导的急性肾损伤(CI-AKI)的较高风险,但pPCI后肾功能的恶化也可能是由于多种其他因素导致。2017年6月,发表在《J Am Heart Assoc.》的一项研究调查了造影剂暴露和pPCI后AKI发生率之间的因果关系。请看本期多学科讨论组临床药师各抒己见为您梳理本文看点—— 背景:pPCI后急性