Lee Un Joo, Kim Hyun Soo, Lee Cheolhyun, Kim Kwang-Yeol, Kim Weon
Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea.
Chonnam Med J. 2014 Dec;50(3):112-4. doi: 10.4068/cmj.2014.50.3.112. Epub 2014 Dec 17.
Percutaneous coronary intervention (PCI) of stumpless chronic total occlusion (CTO) lesions with a side branch stemming from the occlusion have a significantly lower treatment success rate because physicians cannot identify an accurate entry point with only conventional angiographic images. An intravascular ultrasonography (IVUS)-guided wiring technique might be useful for the penetration of stumpless CTO. We recently experienced thrombotic occlusion during an IVUS-guided stumpless CTO procedure. The cause of the thrombosis is not completely understood; the thrombosis may have been associated with the long use of the IVUS catheter. Special precautions should be taken to prevent thrombus in such cases.
对源自闭塞病变的有侧支的无残端慢性完全闭塞（CTO）病变进行经皮冠状动脉介入治疗（PCI）时，治疗成功率显著较低，因为医生仅通过传统血管造影图像无法确定准确的进入点。血管内超声（IVUS）引导的导丝技术可能有助于穿透无残端CTO。我们最近在一次IVUS引导的无残端CTO手术中经历了血栓形成性闭塞。血栓形成的原因尚未完全明确；血栓形成可能与IVUS导管的长时间使用有关。在这种情况下，应采取特殊预防措施以防止血栓形成。
