| Coronary artery chronic total occlusion (CTO) lesions is the common phenomenon in coronary angiography,it refers to the non-coronary antegrade blood flow, the distal vascular of occlusion developed by collateral circulation.Because of the establishment of collateral circulation, in the process of Coronary artery chronic total occlusion, clinical symptoms such as angina (see more patients with unstable angina)also can express as cardia insufficiency. Chronic occlusion myocardial ischemia can decrease the number of myocardial cells and cause the movement of ventricular wall out of step ,can reduce ventricular contractility , lower the quality of life. Good collateral circulation can reduce myocardial ischemia and the scope of myocardial necrosis,Protect the function of left ventricular and improve the prognosis of patients. But collateral vessels provide blood can not fully meet the needs of myocardial metabolism, can not meet the working load,lead to myocardial ischemia,the conventional medical treatment does not reduce the risk caused by coronary artery occlusion, patients with CTO need revascularization. The Survival of viable myocardium is precondition of CTO interventional treatment. Chronic occlusive lesions after successful PCI,the blood flow of ischemic myocardium can be restored , the contractility of myocardium in ischemic region can be improved,the function of Hibernating myocardium can be restored,the physiological function of myocardial cells can be restored, the quality of life can be improved .Because CTO interventional treatment has low success rate so it has been regarded as unsuitable interventional therapy, in recent years, with percutaneous coronary intervention (PCI) equipment improvements,the accumulation of experience, especially the application of stent, the PCI success rate of total occlusion lesions has improved, PCI can be used as an important revascularization therapy. Failure cases, the majority of patients with collateral circulation and the time of Vascular occlusion is longer, suggesting that the success of the intervention or not has relation to vascular occlusion time. Therefore, patients with coronary artery disease should early coronary angiography , early interventional treatment ,to avoid the deterioration of cardiac function caused by long-term chronic ischemic.The prevention of Restenosis after PCI and in-stent restenosis is more troublesome problem at present. The application of Drug-eluting stent (DES) is a progress in Solving the problem of restenosis.Many clinical observations indicate that PCI is effective, the overall long-term effect is the same as CABG,compare with CABG, PCI has the advantages of need no general anesthesia,minor trauma,quick recovery, and also better than drug therapy, thus easily accepted by the majority of patients with coronary heart disease. PCI is effective treatment methods to chronic occlusive lesions.Objective To investigate the effect of successful percutaneous coronary intervention (PCI) treatment on quality of life and prediction in patients with Chronic coronary artery (coronary) totally occluded lesions.Methods 41 patients with chronic total occlusion who had underwent PCI were studied,male:29persons,female:12persons.22 patients had successfully revascularized and stented,male:15 persons ,female:7 persons, 55.50±9.98 years old.19 patients failed to revascularize, male:14 persons ,female:5 persons, 56.84±8.51 years old.We adopt regular out-patient clinic and telephone follow-up ,the daily activities,the number of Angina,the number of days hospitalized again,Cardiac Function and cardiac events,the cases of revascularization again of two groups were observed.Results the clinical follow-up time of two groups is 6 to 24 months, self-care ability and Cardiac Function in patients with successful revascularization were better than those in patients who failed to revascularize, left ventricular ejection fraction in Success group was significantly increased than unsuccess group, weekly angina attack frequency and the number of days hospitalized again less than unsuccess group, the cases of revascularization again have obvious differences between two groups , but the two groups of cardiac events (death and re-infarction cases) did not show significant differences.Conclusion in the course of Chronic coronary artery occlusion developed the collateral circulation, which can provide blood for the ischemic myocardium,it can alleviate myocardial ischemia, but the collateral vessels provide blood can not fully meet the needs of myocardial metabolism, can not eliminate exercise-induced myocardial ischemia. successful PCI for chronic Occlusive lesions ,coronary blood flow can be improved, angina alleviated, the quality of life improved. PCI has greater difficulty ,the longer occlusion,the low success rate, early coronary angiography and interventional therapy to patients with chronic occlusion can improve the success rate and security of intervention treatment. Drug-eluting stents has positive significance in the prevention of restenosis . |
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