Mohandes Mohsen, Rojas Sergio, Guarinos Jordi, Fernández Francisco, Oliva Xavier, Noueched Marianela, Bardaji Alfredo
Honorary Professor, Interventional Cardiology Unit, Cardiology Division, Joan XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain.
Interventional Cardiology Unit, Cardiology Division, Joan XXIII University Hospital, Tarragona, Spain.
ARYA Atheroscler. 2016 Jul;12(4):206-211.
Balloon advancement and dilation through chronic total occlusion segment could be challenging in some cases after successful wire crossing. The purpose of this study was to evaluate efficacy and safety of Tornus catheter (Asahi Intecc; Aichi, Japan) in percutaneous coronary intervention of chronic total occlusion in hard or balloon-uncrossable chronic total occlusion.
The present study is a retrospective and descriptive analysis of 14 hard or balloon-uncrossable chronic total occlusions treated percutaneously in our catheterization laboratory (cath lab). Tornus catheter was used to penetrate and eventually cross the chronic total occlusion segment. Procedure success was defined when Tornus penetrated at least partly into chronic total occlusion segment making possible the subsequent balloon dilatation and stent implantation achieving a final TIMI III angiographic result with residual stenosis less than 30%. Switch to other microcatheter was considered as an unsuccessful procedure. Complications associated with the Tornus use were analyzed in order to evaluate device safety.
The average age of patients was 65.2 ± 9.6 and 11 out of 14 (78.6%) were male. In 7 (50%) cases, Tornus was used after an unsuccessful balloon passage through occluded segment. In 11 (78.6%) out of 14 cases the procedure was successful and in 3 (21.4%) cases, the operator switched to another microcatheter to continue with the procedure. No complication occurred during all procedures.
Tornus catheter can be effectively and safely used in a subgroup of patients undergoing percutaneous coronary intervention of chronic total occlusion with hard or balloon-uncrossable lesions and could facilitate the treatment of this type of lesions.
在成功通过导丝穿过慢性完全闭塞病变段后,某些情况下球囊推进和扩张穿过慢性完全闭塞段可能具有挑战性。本研究的目的是评估Tornus导管(日本爱知县旭化成株式会社)在硬或球囊无法穿过的慢性完全闭塞病变经皮冠状动脉介入治疗中的有效性和安全性。
本研究是对在我们导管室经皮治疗的14例硬或球囊无法穿过的慢性完全闭塞病变进行的回顾性描述性分析。使用Tornus导管穿透并最终穿过慢性完全闭塞段。当Tornus至少部分穿透慢性完全闭塞段,使得随后能够进行球囊扩张和支架植入,并获得最终TIMI III级血管造影结果且残余狭窄小于30%时,定义为手术成功。改用其他微导管被视为手术失败。分析与使用Tornus相关的并发症以评估器械安全性。
患者的平均年龄为65.2±9.6岁,14例中有11例(78.6%)为男性。7例(50%)患者在球囊通过闭塞段失败后使用了Tornus导管。14例中有11例(78.6%)手术成功,3例(21.4%)患者手术中改用了另一种微导管。所有手术过程中均未发生并发症。
Tornus导管可有效且安全地用于患有硬或球囊无法穿过的病变的慢性完全闭塞经皮冠状动脉介入治疗的亚组患者,并可促进此类病变的治疗。