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一根6F引导导管和一根微导管用于完成逆行慢性完全闭塞病变介入治疗：“反向送入”或“内视镜”技术。

One 6-F Guiding Catheter and One Microcatheter to Accomplish a Retrograde Chronic Total Occlusion Approach: The "Reverse Tip-In" or "Introspect" Technique.

作者信息

Firouzi Ata, Hosseini Zahra, Khalilipur Ehsan

机构信息

Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Case Rep Cardiol. 2022 Jul 18;2022:2952898. doi: 10.1155/2022/2952898. eCollection 2022.

DOI:10.1155/2022/2952898
PMID:35898670
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9314161/
Abstract

The retrograde approach has significantly increased the overall success rate of chronic total occlusion (CTO) percutaneous coronary intervention (PCI), up to 90% in the hands of experienced CTO operators. The "tip-in" technique involves inserting an antegrade microcatheter over the retrograde guidewire, allowing for antegrade intervention on the CTO segment. Through the presentation of the following case, we want to illustrate how to undertake a retrograde approach to bridge the occluded segment via the "reverse tip-in" or "introspect" technique, using a single guiding catheter with one microcatheter inside.

摘要

逆向技术显著提高了慢性完全闭塞病变（CTO）经皮冠状动脉介入治疗（PCI）的总体成功率，在经验丰富的CTO介入操作者手中，成功率高达90%。“送入尖端”技术是指在逆向导丝上插入一根顺向导丝微导管，从而能够对CTO节段进行顺向介入治疗。通过以下病例展示，我们想要说明如何采用逆向技术，通过“反向送入尖端”或“深入观察”技术，使用一根带有一根微导管的单根引导导管来跨越闭塞节段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9db3/9314161/6a3778641d4d/CRIC2022-2952898.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9db3/9314161/176ccafb9811/CRIC2022-2952898.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9db3/9314161/6a3778641d4d/CRIC2022-2952898.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9db3/9314161/176ccafb9811/CRIC2022-2952898.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9db3/9314161/6a3778641d4d/CRIC2022-2952898.002.jpg

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本文引用的文献

1
Retrograde Approach to Chronic Total Occlusion Percutaneous Coronary Intervention.逆行技术开通慢性完全闭塞病变的经皮冠状动脉介入治疗
Circ Cardiovasc Interv. 2020 May;13(5):e008900. doi: 10.1161/CIRCINTERVENTIONS.119.008900. Epub 2020 Apr 27.
2
Outcomes with retrograde versus antegrade chronic total occlusion revascularization.逆行与顺行慢性完全闭塞血运重建的结果。
Catheter Cardiovasc Interv. 2020 Nov;96(5):1037-1043. doi: 10.1002/ccd.28616. Epub 2019 Nov 28.
3
"Tip-in" technique for retrograde chronic total occlusion revascularization.
用于逆行性慢性完全闭塞病变血管重建的“嵌入”技术。
J Invasive Cardiol. 2015 May;27(5):E62-4.
4
Retrograde percutaneous recanalization of chronic total occlusion of the coronary arteries: procedural outcomes and predictors of success in contemporary practice.经皮逆行冠状动脉慢性完全闭塞再通术：当代实践中的程序结局和成功预测因素。
Circ Cardiovasc Interv. 2009 Apr;2(2):124-32. doi: 10.1161/CIRCINTERVENTIONS.108.838862. Epub 2009 Feb 20.
5
The efficacy of a bilateral approach for treating lesions with chronic total occlusions the CART (controlled antegrade and retrograde subintimal tracking) registry.经皮冠状动脉介入治疗慢性完全闭塞病变中双侧入路的疗效：CART（控制性正向和逆向内膜下寻径）注册研究。
JACC Cardiovasc Interv. 2009 Nov;2(11):1135-41. doi: 10.1016/j.jcin.2009.09.008.
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Retrograde coronary angioplasty of isolated arterial segments through saphenous vein bypass grafts.通过大隐静脉旁路移植对孤立动脉段进行逆行冠状动脉血管成形术。
Cathet Cardiovasc Diagn. 1990 Jun;20(2):88-93. doi: 10.1002/ccd.1810200205.