Nghiên cứu kết quả can thiệp động mạch vành qua da sang thương tắc hoàn toàn mạn tính

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Quang Bình Trương, Hoàng Vũ Vũ

Ngôn ngữ: Vie

Ký hiệu phân loại: 612.1 Blood and circulation

Thông tin xuất bản: Y học cộng đồng 2022

Mô tả vật lý: 199-205

Bộ sưu tập: Metadata

ID: 398646

Thêm vào giỏ Liên kết toàn văn

Can thiệp sang thương tắc hoàn toàn mạn tính (THTMT) là thử thách lớn trong can thiệp động mạch vành (ĐMV) qua da với tỉ lệ thất bại thủ thuật cao hơn can thiệp các sang thương khác. Các nghiên cứu về kết quả can thiệp qua da sang thương THTMT tại Việt Nam không nhiều nên chúng tôi tiến hành nghiên cứu này nhằm có thêm dữ liệu về kết quả can thiệp sang thương THTMT ĐMV. Mục tiêu: Xác định tỉ lệ thành công, các yếu tố liên quan thất bại của thủ thuật can thiệp qua da sang thương THTMT ĐMV. Phương pháp: Nghiên cứu quan sát trên 194 bệnh nhân được can thiệp ĐMV qua da sang thương THTMT tại Bệnh viện Đại học Y Dược TP Hồ Chí Minh, từ 04/2017 đến 06/2019. Kết quả: Bệnh nhân có tuổi trung bình là 67,3±11,3
với 73,7% nam cao so với nữ
82,5% có tiền sử ghi nhận tăng huyết áp, 26,3% nhồi máu cơ tim cũ, can thiệp ĐMV qua da trước đây (26,3%), đái tháo đường (29,9%), bệnh thận mạn (9,8%) và 77,4% bệnh nhân nhập viện vì hội chứng vành cấp. Điểm SYNTAX I trung bình là 21,7±7,2. Tỉ lệ thành công chung của thủ thuật là 87,1%. Các yếu tố liên quan đến thất bại thủ thuật gồm có: chỉ số BMI >
25kg/m2
điểm J-CTO cao
điểm J-CTO ³3
mỏm gần không rõ
mạch máu xoắn vặn
mạch máu vôi hoá
chiến lược can thiệp ngược dòng, và không sử dụng siêu âm trong lòng mạch. Kết luận: Nghiên cứu can thiệp ĐMV qua da sang thương THTMT có tỉ lệ thành công thủ thuật tương đối cao (87,1%)
yếu tố tiên lượng thất bại bao gồm: bệnh nhân thừa cân
thang điểm J-CTO cao, J-CTO ³ 3
mạch máu xoắn vặn và vôi hoá
mỏm gần không rõ, chiến lược can thiệp ngược dòng và không sử dụng siêu âm trong lòng mạch., Tóm tắt tiếng anh, Chronic Total Occlusion (CTO) is a significant challenge in percutaneous coronary intervention on account of the high likelihood of interventional failure. Due to lack of data regarding this procedure in Vietnam, we conducted this study to gather additional data on CTO intervention in diverse patient populations. Objectives: (Determine the success rate and the variables associated with procedural failure of percutaneous coronary intervention for chronic total occlusion lesions) Methods: We conducted a observational trial on patients undergoing percutaneous coronary intervention for chronic total occlusion lesions at University Medical Center Ho Chi Minh City, from April 2017 to June 2019. Results: The mean age of the study participants was 67.3±11.3, and 73.7% of them were male. Co-morbidities were hypertension (82.5%), old myocardial infarction (26.3%), prior percutaneous coronary intervention (26.3%), diabetes mellitus (29.9%), chronic kidney disease (9.8%). Acute coronary syndrome was diagnosed in 77.4% of patients. SYNTAX I average score was 21.7±7.2. The procedural success rate was 87.1%, and the characteristics associated with procedural failure were BMI >
25kg/m2 , high J-CTO score, J-CTO score ≥ 3
ambiguous proximal cap, turtuos vessel, cacified vessel and retrograde CTO approach and without use of intravascular ultrasound. Conclusion: Our study found that the successful rate of percutaneous coronary intervention for chronic total occlusion lesion is high (87.1%) and variables associated with procedural failure are BMI >
25 kg/m2
high J-CTO score, J-CTO score ≥ 3, tortuous and calcified vessel, blunt stump, retrograde CTO approach and without use of intravascular ultrasound.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR