逆向导丝技术治疗慢性完全闭塞病变的操作与技巧
徐泽升,霍勇
摘要(Abstract)：
<正>慢性完全闭塞病变(chronic total occlusion,CTO)的成功开通,可以降低死亡率,避免或延迟冠状动脉搭桥。专用器械的研制、经验的积累、技术的提高使CTO开通的成功率明显提高。大多数CTO病变可以通过前向导丝技术(antegrade technique)完成,近期报道的逆向导丝技术(retrograde technique),可以提高复杂CTO病变的开通率。逆向导丝技术操作技巧较高,国外文献进行了系统的总结[1-2]。我们就逆向导丝技术的病例选择、指引导管选择、侧支途径选择、逆向导丝如何通过侧支、逆向导丝如何通过闭塞病变、球囊如何扩张CTO病变、影像学技术支持、并发症预防等操作技巧进行总结,旨在提高CTO开通率,降低并发症。
关键词(KeyWords)：
基金项目(Foundation):
作者(Author): 徐泽升,霍勇
参考文献(References)：
- [1]Wu EB,Chan WW,Yu CM.Retrograde chronic total occlusion intervention:tips and tricks.Catheter Cardiovasc Interv,2008,72:806-814.
- [2]Saito S.Different strategies of retrograde approach in coronary angioplasty for chronic total occlusion.Catheter Caediovasc Interv,2008,71:8-19.
- [3]Wu CJ,Fang HY,Cheng CI,et al.The safaty ang feasibility of bilateral radial approach in chronic total occlusion percutaneous coronary intervention.Int Heart J,2011,52:131-138.
- [4]葛均波,葛雷,马剑英,等.扩张微导管在冠状动脉慢性完全闭塞病变中的应用.中国介入心脏病学杂志,2010,18:1-4.
- [5]Otsuka Y,Nakamura K,Saito T.Usefulness of the Corsair microcatheter for treatment of complex chronic total occlusion.J Invasive Cardiol,2012,24:E35-E38.
- [6]Muramatsu T,Tsukahara R,Ito Y.″Rendezvous in coronary″technique with the retrograde approach for chronic total occlusion.J Invasive Cardiol,2010,22:E179-E82.
- [7]葛均波,主编.冠状动脉慢性完全闭塞病变介入治疗.北京:人民卫生出版社,2009:84-125.
- [8]Surmely JF,Tsuchikane E,Katoh O,et al.New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking:the CART technique.J Invasive Cardiol,2006,18:334-338.