1st Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece.
Hellenic J Cardiol. 2011 Jan-Feb;52(1):79-83.
We report the case of an unsuccessful attempt at recanalisation of a chronic total occlusion via the retrograde approach, and describe a rare complication, guide wire entrapment in the donor artery and septal branch. Several conventional attempts to retrieve the guide wire were unsuccessful and led to wire fracture. A new approach, involving very deep guiding catheter intubation followed by a double guide wire rotary motion, was then used to retrieve the proximal end of the wire fragment and re-engage the uncoiled segment within the distal part of the donor artery. After assessment of the length of the remaining distal end of the wire segment with intravascular ultrasound, stent implantation crushed the wire filament to the vessel wall.
我们报告了一例通过逆行途径对慢性完全闭塞进行再通的尝试失败的病例，并描述了一种罕见的并发症，即导丝嵌顿在供体动脉和间隔支。多次尝试用传统方法取回导丝都未能成功，导致导丝断裂。随后采用一种新方法，即深入引导导管插入，然后进行双导丝旋转运动，将导丝碎片的近端取出，并将未卷曲的部分重新插入供体动脉的远端。在用血管内超声评估剩余的导丝远端长度后，支架植入将导丝细丝压入血管壁。
