Department of Cardiology, Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK.
Catheter Cardiovasc Interv. 2022 Nov;100(6):1030-1035. doi: 10.1002/ccd.30426. Epub 2022 Oct 13.
Facilitated antegrade dissection re-entry (F-ADR) is a technique described for treating post coronary artery bypass surgery chronic total occlusions (CTO) when there is flush occlusion of the distal cap of the CTO at the vein graft anastomosis. In this scenario retrograde access is usually impossible and if antegrade wiring fails, F-ADR is then the best option. Following antegrade dissection past the anastomosis, a balloon is delivered via the vein graft and inflated in the native vessel distal to the anastomosis to facilitate re-entry using a Stingray catheter. However, the applicability and outcome of this technique have not been described in cases where the graft to native vessel anastomosis has previously been stented. We report a case series of successful CTO recanalization using F-ADR across stented graft-native vessel anastomoses.
顺行内膜下夹层重入技术（F-ADR）是一种用于治疗冠状动脉旁路移植手术后慢性完全闭塞（CTO）的技术，当 CTO 的远端帽在静脉移植物吻合口处呈平齐闭塞时。在这种情况下，逆行入路通常是不可能的，如果顺行导丝失败，那么 F-ADR 是最佳选择。在顺行解剖通过吻合口后，通过静脉移植物输送球囊，并在吻合口远端的原生血管内充气，以使用 Stingray 导管方便再进入。然而，在先前已经对移植物到原生血管吻合口进行支架置入的情况下，该技术的适用性和结果尚未被描述。我们报告了一组成功使用 F-ADR 经支架置入的移植物-原生血管吻合口进行 CTO 再通的病例系列。
