Ng Ramford, Hui Peter Y, Beyer Anna, Ren Xiushui, Ochiai Masahiko
Division of Cardiology, California Pacific Medical Center, 2333 Buchanan Street, Room 1-109, San Francisco, CA 94115, USA.
J Invasive Cardiol. 2010 Jan;22(1):E16-8.
Since the introduction of the retrograde technique, the success rate of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has increased significantly in patients with suitable anatomy. To our knowledge, retrograde recanalization of a CTO from the abluminal side of a previously placed stent has not been reported. We describe a case of retrograde PCI of a mid left anterior descending (LAD) artery CTO through a previously placed proximal LAD stent which extended into the diagonal artery. The occluded mid LAD was recanalized using the retrograde approach in which retrograde wire crossing into the proximal LAD was successful only after high pressure balloon expansion of the previously placed proximal LAD-to-diagonal stent. Intravascular ultrasound imaging was also used to confirm an intraluminal location of the retrograde guidewire.
自从逆行技术引入以来，在解剖结构合适的患者中，慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）的成功率显著提高。据我们所知，此前尚未有关于通过先前置入支架的管腔外侧面进行CTO逆行再通的报道。我们描述了一例通过先前置入的延伸至对角支动脉的左前降支（LAD）近端支架，对中段LAD动脉CTO进行逆行PCI的病例。使用逆行方法对闭塞的中段LAD进行再通，其中仅在对先前置入的近端LAD至对角支支架进行高压球囊扩张后，逆行导丝成功穿过至近端LAD。还使用血管内超声成像来确认逆行导丝位于管腔内。
