Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
JACC Cardiovasc Interv. 2012 Jan;5(1):1-11. doi: 10.1016/j.jcin.2011.10.011.
Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Retrograde chronic total occlusion recanalization has recently become an essential complement to the classical antegrade approach. In experienced hands, the retrograde technique currently has a high success rate with a low complication profile, despite frequent utilization in the most anatomically and clinically complex patients. Since its initial description, important changes have occurred that make the technique faster and more successful. We propose a step-by-step approach of the technique as practiced at experienced centers in North America. Because the technique can vary substantially, we describe the different alternatives to each step and offer what we perceived to be the most efficient techniques.
慢性完全闭塞血管开通术仍然是经皮冠状动脉介入治疗的最后堡垒。逆行慢性完全闭塞血管开通术最近已成为经典顺行方法的重要补充。在有经验的术者手中，尽管经常应用于解剖和临床最复杂的患者，逆行技术目前具有较高的成功率和较低的并发症发生率。自最初描述以来，该技术发生了重要的变化，使其更快、更成功。我们提出了一种在北美有经验的中心实践的该技术的逐步方法。由于该技术有很大的差异，我们描述了每一步的不同替代方案，并提供了我们认为最有效的技术。
