Fung Raymond Chi-Yan, Chan Chi-Kin
Division of Cardiology, Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, People’s Republic of China.
J Invasive Cardiol. 2012 May;24(5):242-4.
We reported a case of successful recanalization of a left anterior descending (LAD) artery chronic total occlusion (CTO) with 'integrate guidewire probing technique.' After we mistakenly deployed a stent at the proximal LAD from left main (LM) into a diagonal branch across the mid LAD, this mid LAD CTO became further jailed under the stent. Antegrade wiring of this CTO lesion became exceptionally difficult. After several unsuccessful attempts with different guidewires and interventional techniques, we placed a retrograde microcatheter into the CTO lesion with its tip just situated at the stent strut. An antegrade guidewire supported by another microcatheter was targeted at the tip of the retrograde microcatheter and successfully crossed the CTO lesion. The LAD was successfully recanalized. This technique appeared to be feasible and safe to facilitate antegrade wire crossing of the CTO lesion.
我们报告了一例采用“整合导丝探查技术”成功再通左前降支（LAD）动脉慢性完全闭塞（CTO）的病例。在我们误将支架从左主干（LM）向横跨LAD中段的对角支近端LAD处置入后，该LAD中段CTO在支架下进一步被封堵。该CTO病变的正向布线变得异常困难。在使用不同导丝和介入技术进行多次不成功的尝试后，我们将一根逆行微导管置入CTO病变，其尖端恰好位于支架支柱处。由另一根微导管支撑的正向导丝对准逆行微导管的尖端，并成功穿过CTO病变。LAD成功再通。该技术在促进CTO病变正向导丝穿过方面似乎是可行且安全的。
