Bifurkacije u kontekstu PKI HTO – uvid u registar HTO jednog centra u Beogradu
Sažetak
Uvod/Cilj. Hronične totalne okluzije (HTO) koronarnih arterija su i dalje među najsloženijim procedurama u lečenju koronarnih arterija. Ukoliko postoji bifurkaciona lezija u sklopu HTO, to je jedan od najvećih izazova za interventne kardiologe. Metode. Prikazujemo restrospektivnu analizu bolesnika lečenih u našem centru, kojima je rađena perkutana koronarna intervencija (PKI) sa bifurkacionom lezijom unutar HTO i bočnom granom dijametra 2 mm ili više, od januara 2017. do decembra 2020. godine. Rezultati. Od ukupno 216 bolesnika lečenih u četvorogodišnjem periodu, 38 (18%) ih je imalo bifurkacionu leziju u sklopu HTO. Najčešće bifurkacione lezije (50%) bile su na prednjoj descendentnoj koronarnoj arteriji, a najređe (21%) na cirkumfleksnoj koronarnoj arteriji. Uspešna rekanalizacija HTO ostvarena je kod 35 (92%) bolesnika. Tehnika jednim stentom korišćena je kod 27 (77%) bolesnika, dok je tehnika sa dva stenta korišćena kod 8 (23%) bolesnika. Zaključak. Bifurkacione lezije u kontekstu PKI HTO su relativno čest nalaz na koronarografiji i predstavljaju poseban izazov za HTO operatore. Provisional tehnika (tehnika jednim stentom) najčešća je strategija lečenja bifurkacionih lezija i kod bolesnika sa HTO.
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