Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, People's Republic of China.
The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Clin Interv Aging. 2023 Jun 11;18:933-940. doi: 10.2147/CIA.S404818. eCollection 2023.
The septal collateral channel (CC) is the preferred channel in retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). However, reports on the utilization of the ipsilateral septal CC are limited.
To evaluate the feasibility and safety of the ipsilateral septal CC in retrograde CTO PCI.
Twenty-five patients with successful wire CC tracking via the ipsilateral septal CC in retrograde CTO PCI were retrospectively analyzed. All procedures were performed by experienced CTO operators. Procedures were divided into the left descending coronary artery (LAD)-septal-LAD group and the LAD-septal-left circumflex coronary artery (LCX) group. Procedural complications and in-hospital outcomes were ascertained.
Both groups were similar with respect to risk factors and angiographic characteristics of the CTO, except for the collateral tortuosity (86.7% vs 20%, =0.002). The success rate of microcatheter CC tracking was 96%. Both technical success and procedural success rates were 92%. Procedural complications were found in one case (septal perforation, 4%), which happened in the LAD-septal-LAD group (=0.250). One postoperative adverse event (Q-wave myocardial infarction, 4%) was observed before discharge.
The retrograde approach via the ipsilateral septal CC was feasible, with high success rates and acceptable complications, in the hands of experienced operators.
间隔支侧支循环（CC）是慢性完全闭塞（CTO）逆行经皮冠状动脉介入治疗（PCI）的首选途径。然而，关于同侧间隔 CC 的应用报道有限。
评估同侧间隔 CC 在逆行 CTO PCI 中的可行性和安全性。
回顾性分析了 25 例经同侧间隔 CC 逆行 CTO PCI 中成功导丝 CC 追踪的患者。所有手术均由经验丰富的 CTO 操作人员进行。手术分为左前降支（LAD）-间隔-LAD 组和 LAD-间隔-回旋支（LCX）组。确定了手术并发症和住院期间的结果。
两组在 CTO 的危险因素和血管造影特征方面相似，但侧支迂曲程度不同（86.7%比 20%，=0.002）。微导管 CC 追踪的成功率为 96%。技术成功率和手术成功率均为 92%。在 LAD-间隔-LAD 组发生了 1 例手术并发症（间隔穿孔，4%，=0.250）。出院前观察到 1 例术后不良事件（Q 波心肌梗死，4%）。
在经验丰富的术者手中，同侧间隔 CC 的逆行入路是可行的，成功率高，并发症可接受。
