Numasawa Yohei, Sakakura Kenichi, Yamamoto Kei, Yamamoto Shingo, Taniguchi Yousuke, Fujita Hideo, Momomura Shin-Ichi
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan.
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Cardiovasc Revasc Med. 2017 Jun;18(4):295-298. doi: 10.1016/j.carrev.2017.01.009. Epub 2017 Jan 17.
Side branch occlusion, which was one of the common complications in percutaneous coronary interventions, was closely associated with cardiac death and myocardial infarction. Clinical guidelines also support the importance of preservation of physiologic blood flow in SB during PCI to bifurcation lesions. In order to avoid side branch occlusion during stent implantation, we often performed the jailed wire technique, in which a conventional guide wire was inserted to the side branch before stent implantation to the main vessel. However, the jailed wire technique could not always prevent side branch occlusion. In this case report, we described a case of 72-year-old male suffering from angina pectoris. Coronary angiography revealed the diffuse calcified stenosis in the proximal and middle of left anterior descending coronary artery, and the large diagonal branch originated from the middle of the stenosis. To prevent side branch occlusion, we performed a novel side branch protection technique by using the Corsair microcatheter (Asahi Intecc, Nagoya, Japan). In this case report, we illustrated this "Jailed Corsair technique", and discussed the advantage compared to other side branch protection techniques such as the jailed balloon technique.
分支闭塞是经皮冠状动脉介入治疗中常见的并发症之一，与心源性死亡和心肌梗死密切相关。临床指南也支持在对分叉病变进行经皮冠状动脉介入治疗时保持分支内生理性血流的重要性。为了避免在支架植入过程中出现分支闭塞，我们经常采用拘禁导丝技术，即在将支架植入主血管之前，先将一根传统导丝插入分支。然而，拘禁导丝技术并不能总是防止分支闭塞。在本病例报告中，我们描述了一名72岁患心绞痛男性的病例。冠状动脉造影显示左前降支冠状动脉近端和中段弥漫性钙化狭窄，粗大的对角支起源于狭窄中段。为防止分支闭塞，我们使用Corsair微导管（日本名古屋旭化成公司）实施了一种新型分支保护技术。在本病例报告中，我们阐述了这种“拘禁Corsair技术”，并讨论了与其他分支保护技术（如拘禁球囊技术）相比的优势。
