<p>This article presents an analytical review of the existing scores to predict the outcomes of coronary arteries chronic occlusions recanalization, their advantages and disadvantages. It outlines the potential benefits of introduction of these scales in clinical practice and estimates the possibility of application of such scores in modern conditions.</p><p>Received 30 September 2016. Accepted 24 January 2017.</p><p><strong>Financing:</strong> The study had no sponsorship.</p><p><strong>Conflict of interest:</strong> Kretov E.I. served as executive editor of “Endovascular surgery” section. All other authors declare no conflict of interest.</p><p><strong>Author contributions</strong></p><p>Data collection and analysis: Khelimskiy D.A., Ibragimov R.U., Marchenko A.V., Redkin D.A., Grankin D.S.. Drafting the article: Khelimskiy D.A., Shermuk A.A. Critical revision: Khelimskiy D.A., Shermuk A.A., Krestyaninov O.V., Kretov E.I.</p>

Today, the treatment of patients with chronic coronary occlusion is one of the most difficult problems in interventional cardiology. This is due not only to the technical difficulties of endovascular recanalization, but also to the difficulty in selecting patients for whom revascularization will be beneficial. Due to the low evidence base and the conflicting results of large clinical trials, these patients are rarely referred for endovascular recanalization. The purpose of this article is to review the literature and systematize relevant knowledge on the management of patients with chronic coronary occlusion.

<p><strong>Aim.</strong> Coronary artery perforation (CAP) is a rare but severe complication of percutaneous coronary intervention (PCI). The aim of our study was to evaluate the effect and safety of transcatheter embolization by tissue adhesive Histoacryl when treating CAP.<br /><strong>Methods</strong>. As CAP was confirmed, the final composition of the tissue adhesive histoacryl and radiopaque agent Lipiodol was prepared. The perforated vessel was embolized by tissue adhesive Histoacryl via a micro-catheter. There were eleven patients undergoing transcatheter embolization by Histoacryl in treatment of CAP during PCI at Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology from March 2013 to February 2016, and the clinical data of these patients were collected and analyzed retrospectively.<br /><strong>Results</strong>. The lesion morphology of the patients was classified by using the American College of Cardiology/American Heart Association Task Force classification, there were four patients with Class B2 lesions and seven patients with Class C lesions (there also were four patients with chronic total occlusion lesions). According to the Ellis classification of CAP, there were five patients with Class II perforations and six patients with Class III perforations. The causes of perforation were a guide wire (ten patients) and balloon predilation (one patient). Three patients had pericardial effusion. All of the eight patients with CAP underwent transcatheter embolization by Histoacryl. Coronary angiography confirmed that all of them had been embolized successfully. There were no severe postoperative complications. <br /><strong>Conclusion.</strong> Transcatheter embolization by Histoacryl is an effective, safe, cheap, and easy way to treat perforation of small vessels during PCI.</p><p>Received 14 September 2016. Accepted 2 February 2017.</p><p><strong>Financing:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Conflict of interest: Evgeny I. Kretov served as guest editor on this issue on vascular surgery. The other authors declare no conflict of interest.</p><p><strong>Author contributions</strong></p><p>Data collection and analysis: Shermuk A.A., Naryshkin I.A., Grankin D.S., Zubarev D.D., Ibragimov R.U., Baystrukov V.I. Drafting the article: Shermuk A.A., Khelimskiy D.A., Krestyaninov O.V. Critical revision: Shermuk A.A., Khelimskiy D.A., Krestyaninov O.V., Kretov E.I.</p>

Федеральное государственное бюджетное учреждение «Новосибирский научно-исследователь-ский институт патологии кровообращения имени академика Е.Н. Мешалкина» Министерства здравоохранения Российской Федерации, Новосибирск, РоссияЧрезкожное коронарное вмешательство (ЧКВ) при хронических окклюзиях коронарных артерий (ХОКА) представляется как «последний рубеж» в интервенционной кардиологии. В последние годы новые устрой-ства, усовершенствованные методы визуализации и инновационные технологии значительно повысили уровень успеха и безопасность ЧКВ для лечения ХОКА.Благоприятные отдаленные результаты вмешательств и отличные характеристики стентов с лекарствен-ным покрытием демонстрируют предпочтение ЧКВ для реканализации ХОКА.Подробные знания гистопатологической характеристики ХОКА имеют решающее значение, чтобы по-нять основные принципы передовых интервенционных методов. Понимание принципа антеградного и ретроградного подходов завершают арсенал необходимых навыков для интервенционных кардиологов, занимающихся этой сложной проблемой.Что касается стратегий, методы прохождения сложных поражений постоянно развиваются. Нашей це-лью было представить систематический обзор текущих методик реваскуляризации ХОКА в контексте опу-бликованных результатов применения данных подходов различными центрами, а также решить вопрос о выборе метода реваскуляризации в конкретных клинических условиях.Ключевые слова: хроническая окклюзия коронарных артерий (ХОКА); чрезкожные коронарные вмеша-тельства (ЧКВ); антеградная реканализация; ретроградная реканализация. Percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) has been referred to as the "last frontier" in interventional cardiology. In recent years, new devices, improved imaging techniques and innovative technologies significantly increased the success rate and safety of PCI for treatment of CTO remarkably. Favorable long-term data on the outcomes of interventions, and excellent performance drug-eluting stents show a preference for CTO recanalisation. Detailed knowledge about the histopathological characteristics of CTO is crucial to understand the basic principles of advanced interventional techniques. Understanding the principle of antegrade and retrograde approaches are completing the armamentarium essential for interventional cardiologists dealing with this challenging lesion subset. As strategies fortreating complex lesions are continuously volving. Our goal was to present a systematic review of the current methods for CTO revascularization in the context of the published results of the application of these approaches are different centers, as well as solve the problem of choosing a revascularization method in specific clinical conditions. Keywords: chronic occlusion of the coronary arteries (CTO); percutaneous coronary intervention (PCI); antegrade recanalization; retrograde recanalization. НИИ КПССЗ имеет большой опыт в разработке изделий для сердечно-сосудистой хирургии, в частности биопротезов кла-нов сердца и сосудов. С 2010 года под руководством академика РАН...