Masoomi Reza, Moscardelli Silvia, Hirai Taishi, Azzalini Lorenzo
Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA.
Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA; University of Milan, Milan, Italy.
Prog Cardiovasc Dis. 2025 Jan-Feb;88:20-27. doi: 10.1016/j.pcad.2024.07.001. Epub 2024 Jul 18.
Antegrade techniques are the foundation of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Antegrade wiring with the intent to achieve an intraplaque guidewire tracking is not always feasible, and crossing into the extraplaque space with subsequent reentry (antegrade dissection and reentry), might be needed, particularly in more complex occlusions. The present article reviews in detail the antegrade approaches to CTO PCI, focusing on equipment, techniques, and overcoming challenges.
正向技术是慢性完全闭塞病变(CTO)经皮冠状动脉介入治疗(PCI)的基础。旨在实现斑块内导丝跟踪的正向布线并不总是可行的,可能需要进入斑块外间隙并随后重新进入(正向夹层分离和重新进入),特别是在更复杂的闭塞病变中。本文详细回顾了CTO PCI的正向方法,重点关注设备、技术和克服挑战的方法。