Mohandes Mohsen, Rojas Sergio, Torres Mauricio, Moreno Cristina, Fernández Francisco, Guarinos Jordi, Bardají Alfredo
Interventional Cardiology Unit, Cardiology Division, Joan XXIII University Hospital, Universitat Rovira Virgili, Calle Dr Mallafré Guasch 4, 43007 Tarragona, Spain.
Cardiology Division, Joan XXIII University Hospital, Universitat Rovira Virgili, Calle Dr Mallafré Guasch 4, 43007.
Cardiovasc Revasc Med. 2017 Sep;18(6S1):2-6. doi: 10.1016/j.carrev.2016.12.016. Epub 2016 Dec 27.
We present two cases with chronic total occlusion of the saphenous vein graft in two patients with a history of previous bypass surgery with unfavorable anatomic features for recanalization of the native coronary artery. In the first case, two dedicated attempts for recanalization of chronic total occlusion of the native artery failed and in the second case there was not an adequate visualization of the native vessel beyond the occlusion point, not even by contralateral injection. Excimer laser atherectomy was used in both cases as an adjuvant therapy during recanalization of the saphenous vein graft in combination with a distal protection device in order to reduce distal embolization. The procedures proved successful after stent implantation in the whole length of the saphenous vein grafts and the patients suffered no remarkable events during hospitalization.
我们报告两例隐静脉移植物慢性完全闭塞的病例，两名患者均有既往搭桥手术史，其解剖结构不利于对自身冠状动脉进行再通。在第一例中，两次专门尝试对自身动脉慢性完全闭塞进行再通均失败；在第二例中，即使通过对侧注射，也无法充分显示闭塞点远端的自身血管。两例均在隐静脉移植物再通期间使用准分子激光斑块切除术作为辅助治疗，并联合远端保护装置，以减少远端栓塞。在隐静脉移植物全长植入支架后，手术证明成功，患者在住院期间未发生明显事件。
