Sheiban Imad, Dharmadhikari Aniruddha, Tzifos Vaios, Marsico Federica, Leonardo Filippo, Rosano Giuseppe, Montorfano Matteo, Pagnotta Paolo, Di Mario Carlo, Colombo Antonio
Department of Internal Medicine, Cardiology Unit - Interventional Cardiology, University of Turin, Italy.
Int J Cardiovasc Intervent. 2000 Jun;3(2):105-110. doi: 10.1080/14628840050516190.
Although chronic total occlusions are encountered frequently in patients with coronary artery disease, an effective strategy to deal with them has yet to be devised. Various new guidewires have been designed in an attempt to negotiate chronic occlusions successfully. The authors have analysed the impact of the Athlete guidewire on procedural success in this lesion subset. METHODS: Sixty-two consecutive patients undergoing percutaneous intervention for chronic total occlusions over a two-year period were retrospectively studied. For the initial attempt, conventional guidewires were used. In case of failure, further attempts were made using the Athlete guidewire. Procedural success rates with the use of conventional and Athlete guidewires were assessed. RESULTS: Failure of the first attempt with the conventional guidewire occurred in 32 (51.6%) patients and success was achieved in 30 (48.4%) patients. In the former patients, a second attempt was made using the Athlete guidewire to cross the occlusion. The second attempt was successful in 20 patients (60%) in whom the first attempt was unsuccessful, while in the remaining 12 (40%) patients the occlusion could not be crossed even during the second attempt and the procedure was then terminated. Following the use of the Athlete guidewire, the success rate increased to 62% (p < 0.001). No complication occurred during the first attempt, while one patient had a coronary perforation using the Athlete guidewire, which was managed successfully without the need for bypass surgery. CONCLUSION: The use of the Athlete guidewire is feasible and safe, and enhances the chances of successfully treating chronic total occlusions during percutaneous coronary revascularization procedures.
尽管冠状动脉疾病患者中经常遇到慢性完全闭塞病变，但尚未设计出有效的应对策略。人们设计了各种新型导丝，试图成功通过慢性闭塞病变。作者分析了Athlete导丝对该病变亚组手术成功率的影响。
回顾性研究了连续62例在两年内接受经皮介入治疗慢性完全闭塞病变的患者。首次尝试时使用传统导丝。若失败，则使用Athlete导丝进一步尝试。评估使用传统导丝和Athlete导丝的手术成功率。
首次使用传统导丝尝试失败的患者有32例（51.6%），成功的患者有30例（48.4%）。对于首次尝试失败的患者，第二次尝试使用Athlete导丝穿过闭塞病变。在首次尝试未成功的20例患者（60%）中，第二次尝试成功，而在其余12例（40%）患者中，即使在第二次尝试时也未能穿过闭塞病变，手术随即终止。使用Athlete导丝后，成功率提高到62%（p<0.001）。首次尝试期间未发生并发症，而使用Athlete导丝时有1例患者发生冠状动脉穿孔，经成功处理，无需进行搭桥手术。
使用Athlete导丝是可行且安全的，并增加了在经皮冠状动脉血运重建手术中成功治疗慢性完全闭塞病变的机会。
