Georgia Heart Institute, Northeast Georgia Health System, Gainesville, Georgia, USA.
Georgia Heart Institute, Northeast Georgia Health System, Gainesville, Georgia, USA.
JACC Cardiovasc Interv. 2024 Oct 28;17(20):2411-2424. doi: 10.1016/j.jcin.2024.09.066.
Dissection and re-entry techniques are essential to achieve safe and effective chronic total occlusion recanalization. Several studies have demonstrated similar outcomes following extraplaque stenting compared with intraplaque stenting. Dissection techniques most often involve the use of knuckled wires to progress within and beyond the chronic total occlusion segment. In this expert consensus document, the authors compare the properties of different polymer-jacketed wires for their use in dissection techniques. The authors also describe 2 principal knuckle wire behaviors, the rolling and the traveling knuckles. Finally, several adjunctive techniques for safer dissection are described.
解剖和再进入技术对于实现安全有效的慢性完全闭塞再通至关重要。几项研究表明，与斑块内支架置入相比，斑块外支架置入的效果相似。解剖技术通常涉及使用带扣导丝在慢性完全闭塞段内和段外推进。在本专家共识文件中，作者比较了不同聚合物护套导丝在解剖技术中的特性。作者还描述了 2 种主要的带扣导丝行为，即滚动带扣和移动带扣。最后，还描述了几种辅助的更安全的解剖技术。
