Yoshinaga Masataka, Muramatsu Takashi, Higami Hiroki, Nasu Kenya
Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan.
Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
Catheter Cardiovasc Interv. 2025 Jan;105(1):124-130. doi: 10.1002/ccd.31296. Epub 2024 Nov 18.
We report two cases of successful percutaneous coronary intervention (PCI) of a chronic total occlusion (CTO) lesion with an anomalous origin of the right coronary artery (AORCA) and challenging guiding catheter engagement using a new 3D virtual reality (VR) guiding catheter simulation system. Appropriate guiding catheter selection is critical for a successful complex PCI. A more suitable guiding catheter size, shape, and position with a robust backup force often leads to the successful completion of more accessible and safer procedures. The present case report highlights that VR simulation provides a greater possibility than usual of pre-procedural planning when selecting appropriate guiding catheters and vascular access. The present VR simulation system is based on three-dimensional volume rendering reconstructions of the computed tomography (CT) imaging data; thus, another strength of this technology is that it does not require radiation or radiocontrast exposure to patients. Therefore, transcatheter interventionalists who usually perform complex PCI should be familiar with this innovative system.
我们报告了两例成功对慢性完全闭塞（CTO）病变进行经皮冠状动脉介入治疗（PCI）的病例，病变的右冠状动脉起源异常（AORCA），且使用新型三维虚拟现实（VR）引导导管模拟系统进行引导导管插入具有挑战性。选择合适的引导导管对于复杂PCI的成功至关重要。更合适的引导导管尺寸、形状和位置以及强大的支撑力通常会使更容易且更安全的手术得以成功完成。本病例报告强调，在选择合适的引导导管和血管通路时，VR模拟比通常情况下为术前规划提供了更大的可能性。当前的VR模拟系统基于计算机断层扫描（CT）成像数据的三维容积再现重建；因此，该技术的另一个优点是它不需要对患者进行辐射或放射性造影剂暴露。因此，通常进行复杂PCI的经导管介入专家应熟悉这一创新系统。
