Utunomiya Makoto, Katoh Osamu, Nakamura Shigeru
Kyoto-Katsura Hospital, Cardiovascular Center, 17 Yamada-Hirao, Nishikyo, Kyoto, 615-8256, Japan.
Catheter Cardiovasc Interv. 2009 Mar 1;73(4):475-80. doi: 10.1002/ccd.21851.
In percutaneous coronary intervention for chronic total occlusion (CTO), the retrograde approach is an advanced technique. To improve the long-term patency rate, stent implantation is necessary for CTO, however, antegrade stent delivery to the lesion is contraindicated in cases where there is an anomalous origin or deviation of the coronary artery, or the edge of a previously implanted stent extends into the aorta. We report a successful case of retrograde stent implantation via a septal perforator in a patient with marked deviation of the RCA origin. In this case, antegrade stent implantation was difficult because antegrade catheter insertion carried a risk of crush deformation of an ostial stent.
在经皮冠状动脉介入治疗慢性完全闭塞病变（CTO）中，逆向技术是一种先进技术。为提高长期通畅率，CTO病变需要进行支架植入，然而，在冠状动脉存在异常起源或走行异常，或先前植入支架的边缘延伸至主动脉的情况下，正向支架输送至病变部位是禁忌的。我们报告了1例通过间隔穿孔支对右冠状动脉（RCA）起源明显异常的患者成功进行逆向支架植入的病例。在该病例中，正向支架植入困难，因为正向导管插入有导致开口处支架挤压变形的风险。
