Shibutani Hiroki, Akita Yuzo, Matsui Yumie, Yoshinaga Masahiro, Karakawa Masahiro, Tsuchikane Etsuo
Division of Cardiology, Osaka Saiseikai Izuo Hospital, Osaka, Japan.
Division of Cardiology, Osaka Saiseikai Izuo Hospital, Osaka, Japan.
Cardiovasc Revasc Med. 2017 Oct-Nov;18(7):517-520. doi: 10.1016/j.carrev.2017.04.002. Epub 2017 Apr 8.
The careful assessment of collateral channels is important for a retrograde approach for a chronic total coronary occlusion (CTO). This case report describes a percutaneous coronary intervention for CTO of the distal right coronary artery with good collateral circulation. All visible collateral channels failed by the retrograde approach; however, the procedure was successful using the distal atrial circumflex (AC) channel. Although this distal channel was poorly visualized on standard coronary angiography, it was clearly contrasted retrogradely from the CTO exit using a super-selective injection through the proximal AC channel as the antegrade flow was obstructed by the anchor balloon. This case highlights a unique super-selective injection with anchor balloon technique for collateral channel assessment.
仔细评估侧支循环对于慢性完全性冠状动脉闭塞（CTO）的逆行介入治疗很重要。本病例报告描述了对右冠状动脉远端CTO且侧支循环良好的经皮冠状动脉介入治疗。所有可见的侧支循环通过逆行方法均未成功；然而，使用远端心房回旋支（AC）通道该手术成功。尽管在标准冠状动脉造影上该远端通道显示不佳，但由于正向血流被锚定球囊阻塞，通过近端AC通道进行超选择性注射，从CTO出口逆行清晰显影。本病例突出了一种用于侧支循环评估的独特的锚定球囊超选择性注射技术。
