Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA.
Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA.
Cardiovasc Revasc Med. 2024 Jan;58:104-108. doi: 10.1016/j.carrev.2023.08.012. Epub 2023 Sep 3.
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) carries a non-negligible risk of coronary perforation. Definitive treatment of a proximal large vessel perforation often requires the use of covered stents; however, the latter carry significant risk of restenosis and thrombosis, and is not feasible if wire control of the distal vessel has not been achieved. We describe two cases of target vessel perforations during CTO PCI which were treated by the intentional creation of dissection flaps using the subintimal tracking and re-entry technique to seal the perforation.
慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）存在不可忽视的冠状动脉穿孔风险。近端大血管穿孔的明确治疗通常需要使用带膜支架；然而，后者存在明显的再狭窄和血栓形成风险，如果未能实现远端血管的导丝控制，则无法使用。我们描述了两例 CTO PCI 期间发生的靶血管穿孔病例，使用内膜下跟踪和再进入技术故意制造夹层瓣来封闭穿孔。
