Dash Debabrata
Thumbay Hospital, Ajman, United Arab Emirates.
Beijing Tiantan Hospital, Beijing, China.
Korean Circ J. 2018 Apr;48(4):277-286. doi: 10.4070/kcj.2017.0345.
It has been estimated that coronary chronic total occlusion (CTO) is encountered in 15 to 20% patients referred for coronary angiography (CAG). The success of percutaneous coronary intervention (PCI) of CTO can be attributed to the vast array of hardware that has now become available and also to the vastly enhanced operator expertise. It is however realistic to state that despite the tremendous increase in the rate of success, there then comes a subset of CTO where PCI attempts fail. The reason for such failures given that other variables remain constant is the inability to cross the CTO lesion. This can be due to a failure to cross the lesion with a guide wire (despite guide wire escalation). The second cause of failure is the inability to cross the lesion with a balloon (balloon-uncrossable [BU] CTO). This can occur despite the successful placement of a guidewire in the distal true lumen. The BU lesions contribute 2% to 10% of CTO PCI failure cases. The author attempts to present a creative solution to assist crossing such lesions.
据估计，在接受冠状动脉造影（CAG）的患者中，15%至20%会出现冠状动脉慢性完全闭塞（CTO）。CTO经皮冠状动脉介入治疗（PCI）的成功可归因于现已可用的大量硬件设备以及操作人员专业技能的大幅提升。然而，现实情况是，尽管成功率大幅提高，但仍有一部分CTO患者的PCI尝试会失败。在其他变量保持不变的情况下，此类失败的原因是无法穿过CTO病变。这可能是由于无法用导丝穿过病变（尽管已升级导丝）。失败的第二个原因是无法用球囊穿过病变（球囊无法穿过的[BU]CTO）。尽管导丝已成功置入远端真腔，但仍可能发生这种情况。BU病变占CTO PCI失败病例的2%至10%。作者试图提出一种创新解决方案，以协助穿过此类病变。
