Anatomical classification of chronic total occlusions in coronary bifurcations.
Anatomical classification of chronic total occlusions in coronary bifurcations.
复制标题
DOI：
10.5603/cj.a2022.0115
复制
发表时间：
2023
影响因子：
2.9
通讯作者：
Mashayekhi, Kambis
中科院分区：
文献类型：
--
作者：
Luis Gutierrez-Chico, Juan;Cortes, Carlos;Holm, Niels Ramsing;Christiansen, Evald Hoj;Lesiak, Maciej;Lauer, Bernward;Otto, Sylvia;Lavarra, Francesco;Sasi, Viktor;Chatzizisis, Yiannis S.;Rathore, Sudhir;Mashayekhi, Kambis
关键词：
冠状动脉分叉病变（CBL）中慢性完全闭塞（CTO）的经皮冠状动脉介入治疗（PCI）正在经历实质性的技术进步和标准化，与专用器械、工具和技术的发展并行。一个标准的共识，分类CTO-CBL可能有助于同质化的数据收集和描述的程序，用于科学和教育目的。Medina-CTO分类复制了Medina分叉分类中的经典三位数，分别代表近端主血管、远端主血管和侧分支。如果涉及动脉粥样硬化并且解剖学上狭窄，则每个数字可以取1，或者如果不是，则取0。此外，分叉处的闭塞段用下标表示，下标描述了帽的关键介入特征：t（锥形）、B（钝）或a（不明确）。这一方法产生了56个基本类别，可根据每项研究的具体需要，按不同要素进行分组。Medina-CTO分类，包括在标准Medina三联体的完全闭塞节段中添加描述基本帽特征的下标，可能是一种有用的方法学工具，用于标准化分叉CTO病变的经皮介入治疗，具有有趣的科学和教育应用。
Percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) in coronary bifurcation lesions (CBL) is undergoing substantial technical progress and standardization, paralleling the evolution of dedicated devices, tools, and techniques. A standard consensus to classify CTO-CBL might be instrumental to homogenize data collection and description of procedures for scientific and educational purposes. The Medina-CTO classification replicates the classical three digits in Medina classification for bifurcations, representing the proximal main vessel, distal main vessel, and side branch, respectively. Each digit can take a value of 1 if it concerns atherosclerosis and is anatomically stenosed, or 0 if it is not. In addition, the occluded segment(s) of the bifurcation are noted by a subscript, which describes key interventional features of the cap: t (tapered), b (blunt), or a (ambiguous). This approach results in 56 basic categories that can be grouped by means of different elements, depending on the specific needs of each study. Medina-CTO classification, consisting of adding a subscript describing the basic cap characteristics to the totally occluded segment(s) of the standard Medina triplet, might be a useful methodological tool to standardize percutaneous intervention of bifurcational CTO lesions, with interesting scientific and educational applications.