目的 探讨CT血管成像(CT angiography, CTA)对冠状动脉慢性完全闭塞病变(chnmic total occlusion, CTO)介入治疗的应用价值。方法 回顾性分析我院62例CTO患者的临床资料, 将术前行CTA检查的32例作为A组;未行CTA检查30例作为B组, 比较两组血管再通率、导丝未通过发生率、并发症发生率, 并对A组治疗成功和失败患者的CTO病变局部平均钙化积分和手术时间进行比较。结果 A组血管再通率为73.17％, B组为42.11％, 两组比较有统计学差异(P＜0.05)。A组血管再通患者平均手术时间(75±30) min, B组为(105±40)min, 两者比较有统计学差异(P＜0.05)。A组介入治疗成功患者CTO病变局部平均CT密度值(400±72)Hu, 介入治疗失败患者为(520±108)Hu, 两者比较有统计学差异(P＜0.01)。结论 CTA检查可提高CTO病变介入治疗成功率, 并减少介入治疗时间;CTO病变平均CT密度值、血管闭塞时间和血管病变长度影响介入治疗成功率。

Objective To study the value of coronary CTA imaging in interventional therapy of chronic coronary artery occlusion(CTO) lesions. Methods The clinical data of 62 patients with CTO were analyzed retrospectively, 32 cases with preoperative CT examination as group A; 30 patients without CTA check as group B. Vascular recanalization rates, guide wire non-passaging rates, and incidence rates of complications in the two groups were compared. Results Blood vessel recanalization rate in group A was 73.17%, and that in group B was 42.11%, with significant difference between the two groups (P<0.05). The an average time of operation in group A with vascular recanalization was (75?30) min; that in group B was (105?40) min, with significant difference (P<0.05). The average density of CT in CTO lesions of group A with successful interventional treatment was (400?72) Hu, whereas that in those with failing intervention treatment was (520?108) Hu, with significant difference (P<0.01). Conclusions CTO lesions mean CT density, vascular occlusion time, and vascular lesion length influence the success rate of interventional therapy; CT examination improves the success rate of interventional therapy CTO lesions and reduces time of interventional therapy.